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目的应用SLNB技术检测甲状腺癌前哨淋巴结,评价染料核素联合定位法的可行性及临床应用情况。方法应用SLNB技术检测在我科住院的46例甲状腺癌患者的前哨淋巴结,男11例,女35例;年龄25～75岁。Ⅰ期21例,Ⅱ期17例,Ⅲ期6例,Ⅳ期2例;有淋巴结转移31例,无淋巴结转移15例;甲状腺乳头状癌28例,滤泡腺癌17例,髓样癌1例。结果 46例甲状腺癌有43例检出SLN,其中SLN共检出65枚,其中1枚的23例,取出2枚的18例,取出3枚的2例。术中行冰冻检出有转移的SLN28枚,术后常规病理检出有转移的SLN31枚。SLN检出率93.4%(43/46),敏感性90.3%(28/31),假阴性率9.7%(3/31)。结论用核素、染料、r计数仪联合检测SLN,检出率较高(93.4%,43/46),敏感性也较高(90.3%,28/31),假阴性率9.7%(3/31)。与国内外报道接近,分别为66%～100%和80%～100%。因此用核素、染料、r计数仪联合检测SLN的方法可靠、准确性高,可以作为常规方法检测SLN。而根据SLN的结果决定是否行颈淋巴结清扫术,将有可能取代传统的颈淋巴结清扫原则。
Objective To detect sentinel lymph node of thyroid cancer using SLNB technique and evaluate the feasibility and clinical application of dye nuclide combined localization method. Methods SLNB technique was used to detect sentinel lymph nodes in 46 cases of thyroid cancer hospitalized in our department. There were 11 males and 35 females, aged 25-75 years old. 21 cases of stage Ⅰ, 17 cases of stage Ⅱ, 6 cases of stage Ⅲ and 2 cases of stage Ⅳ; 31 cases of lymph node metastasis, 15 cases of no lymph node metastasis; 28 cases of thyroid papillary carcinoma, 17 cases of follicular adenocarcinoma, 1 cases of medullary carcinoma 1 example. Results Of the 46 cases of thyroid cancer, 43 cases were detected SLN, of which SLN were detected in 65 cases, of which 23 cases of a, remove two of the 18 cases, out of three in 2 cases. Intraoperative frozen line detected SLN28 transfer, postoperative routine pathological detection of metastatic SLN31. The detection rate of SLN was 93.4% (43/46), the sensitivity was 90.3% (28/31) and the false negative rate was 9.7% (3/31). Conclusions The detection rate of SLN was higher (93.4%, 43/46) with higher sensitivity (90.3%, 28/31) and false negative rate of 9.7% (3 / 31). Close to domestic and foreign reports, respectively, 66% to 100% and 80% to 100%. Therefore, nuclide, dye, r counter combination of SLN detection method is reliable, accurate, SLN can be used as a routine method. According to the results of SLN decide whether to perform cervical lymph node dissection, it will be possible to replace the traditional principles of cervical lymph node dissection.