前哨淋巴结探查在甲状腺乳头状癌外科手术中的应用

Management of the sentinel lymph node of papillary thyroid carcinoma in surgery

目的:探讨甲状腺乳头状癌前哨淋巴结(SLN)的检测及其对颈淋巴结转移的预测价值。方法:用术中在肿瘤周围注射亚甲蓝的方法对25例甲状腺乳头状癌患者进行SLN的临床研究,术中取蓝染淋巴结及颈清淋巴结做常规苏木精-伊红染色病理检查,并将两者进行对照,观察SLN转移对颈淋巴结转移的预测作用。结果:25例患者中22例成功地显示了SLN,成功率为88%,显示的SLN中有19例病理阳性,其中13例颈淋巴结清扫术证实有非SLN的颈淋巴结转移,5例未发现有非SLN的其他淋巴结转移,1例因自身因素未行颈淋巴结清扫术。结论:SLN检测对预测甲状腺乳头状癌淋巴结转移有重要价值。

Objective：To investigate the value of sentinel lymph node of papillary thyroid carcinoma exploring and measuring in the metastasis of the cervical lymph node of thyroid carcinoma. Method：The sentinel lymph node were investigated by injecting the methylene blue around 25 cases of thyroid tumors. The lymph nodes dyed in blue and obtained from selective lymph node dissection were examined by pathology, respectively. The value of the sentinel lymph nod were evaluated. Result：The sentinel lymph nodes dyed in blue were identified in 22 cases which account for 88.0% of all the 25 cases. Nineteen cases of the sentinel lymph node were positive by pathology, of whom 13 cases were verified positive in other area. Six cases were negative. Conclusion：It is of great value that sentinel lymph node of thyroid carcinoma can indicate the metastasis of the cervical lymph node of thyroid carcinoma.