[Sentinel lymph node biopsy in patients with papillary thyroid carcinoma].
The concept of sentinel lymph node (SLN) has been proven to be successful and accurate in surgical decision making for the treatment of some solid tumors. The AIM of this study is to investigate the feasibility and accuracy of the SLN biopsy in patients with papillary thyroid carcinoma.


METHODS
Twenty eight patients underwent SLN biopsy for the period from 01 January 2003 to 30 June 2006 in our institution.Twenty three of them were females and 5 males, at the age of 21 to 57 years. All patients have had a solitary thyroid nodule, 0.8 to 3.0 cm in size. Patients with any palpable or ultrasonografically detectable cervical LNs or history for previous neck surgery and/or radiation in the same region have been excluded from the study. Blue dye (Patent blue V) injection around or inside the thyroid nodule was utilized for the SLN detection followed by SLN biopsy.


RESULTS
SLN have been detected and obtained in all 22 patients with papillary thyroid carcinoma. One SLN in the central compartment was found in 19 (40,9%) patients and one in lateral compartment in 3 (13,6%) patients. In 2 (9,1%) patients one SLN was found in both, central and lateral compartments. Metastasis in SLN was found in 9 (40,9%) patients. SLN in last 13 (59,1%) patients were negative for metastases. From patients with metastasis-positive SLN, metastasis in a next regional lymph node was found in 3 (13,6%) patients. In the remaining 6 cases next lymph nodes in both compartments were metastasis-negative. Metastatic disease in regional lymph nodes was not found in anyone from the patients with metastasis-negative SLN.


CONCLUSIONS
Sentinel lymph node biopsy provides reliable information about the pathomorphological lymph node status in patients with papillary thyroid carcinoma, thus making possible to avoid unnecessary neck dissections and to minimize the risk from local surgical complications and disease recurrencies. The initial results with SLN biopsy give us a reason to accept this technique as a feasible, accurate and safe option in the surgical treatment of papillary thyroid carcinoma.
R
R
Nenkov
R
R
Radev
R
R
Madzhov
I
I
Krasnaliev
D000328:Adult; D002291:Carcinoma, Papillary / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D021701:Sentinel Lymph Node Biopsy; D013964:Thyroid Neoplasms / Q000473:pathology*