SENTINEL LYMPH NODE BIOPSY AS GUIDANCE FOR CENTRAL NECK DISSECTION IN PATIENTS WITH PAPILLARY THYROID CARCINOMA

Abstract

Background: Occult lymph node metastasis of papillary thyroid carcinoma (PTC) can be detected by sentinel lymph node (SLN) biopsy. Aim of the work: Our objective in this study was to evaluate the accuracy of using sentinel lymph node biopsy as a marker to identify occult metastases early. Patients and methods: The present study was a prospectivestudy that was conducted in Ain Shams University Hospitals in Egypt, and included sixty (60) patients who had papillary thyroid carcinoma. The patients underwent sentinel lymph node biopsy with total thyroidectomy during the period between 1st of December 2016 and 1st of December 2018. Results: The study included 60 patients with papillary thyroidcarcinoma, 16 males and 44 females. Size of nodules ranged from 0.5- 4 cm and more nodules were confined to the left lobe (63.3%). SLNs were identified in 44 of 60 malignant cases (73.3%). 38 of identified SLN were positive for metastasis and 22 were negative while non SLN were positive in 31/60 and negative for 29/60. Thus, the sensitivity, specificity, negative predictive values, positive predictive values and accuracy of SLN biopsy were 86.7%, 100%, 72,7%, 100% and 73.3%, respectively. Post-operative complications included temporary symptomatic hypocalcaemia in 3 patients and temporary recurrent laryngeal nerve injury in 2 patients then recovered. Conclusion: SLN biopsy for patients with papillary thyroid carcinoma and negative LNs clinically and radiologically is an accurate and noninvasive means to identify subclinical lymph node metastasis.