The role of Sentinel Lymph Nodes Biopsy Using Blue Dye in the Management of Differentiated Thyroid Carcinoma

Around 1.7 percent of human malignancy is caused by thyroid cancer. In terms of patient health and survival, the disease and its management have a higher mortality and morbidity rates than is desirable. To determine if sentinel lymph node biopsy is effective and feasible for treating the differentiated thyroid cancer with negative nodes clinically and to avoid needless lymph nodes dissection among cases of differentiated thyroid cancer (DTC) as their original lymph nodes did not show any spread. We did this prospective research at Al-Azhar University Hospitals in Egypt, and twenty differentiated thyroid cancer patients were included. Total thyroidectomy with sentinel lymph node biopsy and central neck dissection was done. SNB using methylene blue dye was used exclusively in the early stages of DTC, and afterwards CND was conducted. Sentinel LNs were identified in 17/20 patients. 13 SLN were positive for metastasis and 4/20 (20%) were negative for metastasis. Non sentinel LNs were extracted via central dissection. compartment 14/20 was found positive for metastasis and 6/20 were found negative. Detection rate was 85%. False negative rate was 25% (1/4), sensitivity was 93% (13/14) and specificity was 100% (3/3), accuracy 94 %, PPV was 100% (13/13), while NPV was 75% (3/4). SLN biopsy was capable of discovering hidden lymph node metastases in DTC patients without US or gross clinical lymph node affection and could be utilized to identify those who require a dissection of the central neck. The blue dye approach is also safe and feasible, however, it limits the utility of SLNB in the management of clinically node negative DTC due to its poor detection rate and a significant FNR..