Metastases in axillary sentinel lymph nodes in breast cancer as detected by intensive histopathological work up
Metastases in axillary sentinel lymph nodes in breast cancer as detected by intensive histopathological work up
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DOI：
10.1136/jcp.52.12.922
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发表时间：
1999-12-01
影响因子：
3.4
通讯作者：
Cserni, G
中科院分区：
文献类型：
--
作者：
Cserni, G
目的：评价腋窝前哨淋巴结（SLN）的组织学检查对区域转移性疾病的诊断价值（平均49个水平/SLN）和细胞角蛋白和上皮膜抗原的免疫染色，结果：26个淋巴结中，8个（31%）中央横断面未能发现转移灶乳腺癌转移至SLN的患者。这将导致21例患者中的6例（29%）出现假阴性淋巴结状态。两个微转移检测与immunostains. Conclusions的帮助下，结果表明，需要检查SLN在多个层面和使用免疫组化阴性病例。连续切片在微转移的情况下也是有用的，因为其中一些可能在更深的水平转化为大转移。在标准染色阴性的情况下，SLN和免疫组化的多水平调查将导致分期的改善和检测到的淋巴结阳性疾病的比例增加。
Aim-To assess the value of the intensive histological work up of axillary sentinel lymph nodes (SLN) to demonstrate regional metastatic disease.Methods-From a series of 58 successful lymphatic mapping procedures, 78 SLN were analysed by serial sections (mean of 49 levels/SLN) and by immunostaining to cytokeratin and epithelial membrane antigen, and the results compared with those obtained by assessing the central cross section.Results-The central cross section would have failed to detect metastases in eight of 26 lymph nodes (31%) in patients with breast cancer metastasising to the SLN only. This would have led to a false negative node status in six of 21 patients (29%). Two micrometastases were detected with the aid of immunostains.Conclusions-The results suggest the need to examine SLN at multiple levels ana to use immunohistochemistry in negative cases. Serial sections are also useful in the case of micrometastases, as some of these may convert to macrometastases at deeper levels. Multiple level investigation of SLN and immunohistochemistry in the event of the negativity of standard stains would result in improved staging and an increase in the proportion of node positive disease detected.