Provera strazarskih limfnih nodusa kod tiroidnog karcinoma

Introduction: Sentinel lymph node (SLN) was defined as the first lymph node that the tumor would drain to, within that tumor?s regional lyphatic basin. In 1998, Kelemen and co-workers have published the first results on SLN lymphonodectomy in thyroid carcinomas. Methodology: Different methods have been used in a goal of lymphatic mapping (application of vital blue dye and/or radio colloid). Results: In a period from 2001 to 2003 we have performed SLN biopsy in 64 patients with thyroid tumors. There were 12 cases of thyroid carcinoma. SLN identification rate was 73,44%. We found no false positive or negative results on definitive histopathology. Discussion: The impact of lymph node metastases in differentiated thyroid carcinoma is still controversial. The management of cervical lymph nodes varies from ?berry peacking? to modified radical neck dissection. There is a significant disproportion in percentage of pre and intraoperatively enlarged lymph nodes (27-45%) and histological confirmed lymph node metastases (80-90%) in papillary thyroid carcinoma. In the current literature the average rate of SLN identification is 91% (66-100%) and when identified, the SLN accurately predicts the disease status of the neck in most patients (80-100%).Conclusion: The SLN biopsy for thyroid carcinoma is good and feasible technique for estimating the cervical lymph node status. Uvod. Strazarski limfni nodus (SLN) predstavlja prvi limfni nodus u pripadajucem limfnom drenaznom podrucju, u koji drenira maligni tumor. Kelemen je, 1998. godine, objavio prve rezultate mapiranja i biopsije SLN kod 17 bolesnika sa karcinomom stitaste zlezde. Metodologija: Postoje razlicite metode i tehnike mapiranja strazarskih limfnih nodusa (aplikacija vitalne boje i/ili radiokoloida). Rezultati: U periodu od 2001-2003 godine u Institutu za onkologiju i radiologiju Srbije, uradjena je provera SLN kod 64 bolesnika sa tumorom stitaste zlezde. Registrovano je 12 slucajeva karcinoma. Stepen identifikacije SLN iznosio je 73,44%. Provera svih limfnih nodusa na standardnim HP preparatima nije pokazala lazno pozitivne ni lazno negativne rezultate. Diskusija: Znacaj limfonodalnih metastaza (LNM) kao faktora prognoze kod diferentovanih tiroidnih karcinoma (DTK) predmet je aktuelnih kontroverzi. Opseg operacija na limfnim nodusima krece se od ?ubiranja? (?berry peacking?) do modifikovanih radikalnih i radikalnih disekcija vrata, pa i medijastinuma. Prema razlicitim podacima, ucestalost preoperativno i intraop