Detection of micrometastases in the sentinel lymph nodes of patients with endometrial cancer
Detection of micrometastases in the sentinel lymph nodes of patients with endometrial cancer
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DOI：
10.1016/j.ygyno.2007.01.052
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发表时间：
2007-06-01
影响因子：
4.7
通讯作者：
Yaegashi, Nobuo
中科院分区：
文献类型：
--
作者：
Niikura, Hitoshi;Okamoto, Satoshi;Yaegashi, Nobuo
Objective.我们研究了前哨淋巴结（SLN）定位检测子宫内膜癌微转移的实用性。我们重新评估了SLN检测方法的准确性，这次结合了连续切片和细胞角蛋白免疫染色。2002年3月至2005年3月，在东北大学医院接受剖腹手术（全腹子宫切除术、双侧输卵管卵巢切除术、全盆腔淋巴结切除术和主动脉旁淋巴结切除术至肾静脉水平）并进行SLN活检的子宫内膜癌连续患者入选本研究。排除常规组织学检查发现淋巴结转移或未检出SLN的患者。所有手术切除的淋巴结，包括前哨淋巴结，通过抗细胞角蛋白抗体（AE 1/AE 3）免疫组化染色结合200-500 μ m间隔的连续切片进行组织病理学检查。从20例患者中获得的74个SLN中有4个（5%）有微转移或孤立的肿瘤细胞（ITC）。相比之下，从20例患者中获得的1350个非SLN中只有4个（0.3%）有可检测到的微转移。在髂外盆（2例）和主动脉旁区域（2例）检测到微转移。1例髂外盆内检出孤立性肿瘤细胞。通过我们的方法检测的前哨淋巴结微转移比非前哨淋巴结更频繁。通过免疫染色容易检测微转移只有通过SLN的分步连续切片才有可能。(c)2007年爱思唯尔公司All rights reserved.
Objective. We investigated the utility of sentinel lymph node (SLN) mapping for the detection of endometrial carcinoma micrometastases. We reevaluated the accuracy of our SLN detection procedure, this time combining step-serial section with cytokeratin immunostaining.Patients and methods. Between March 2002 and March 2005, consecutive patients undergoing laparotomy (total abdominal hysterectomy, bilateral salpingo-oophorectomy, total pelvic lymphadenectomy and para-aortic lymphadenectomy to the level of renal veins) with SLN biopsy for endometrial cancer at Tohoku University Hospital were enrolled in this study. Excluded were patients in whom lymph node metastases were detected by routine histological examination or those without detectable SLNs. All surgically removed lymph nodes, including SLNs, were examined histopathologically by immunohistochemistry staining with an anti-cytokeratin antibody (AE1/AE3) combined with step-serial sectioning at 200-500 mu m intervals.Results. Four of seventy-four SLNs (5%) obtained from 20 patients had micrometastases or isolated tumor cells (ITC). In contrast, only 4 of the 1350 non-SLNs obtained from 20 patients (0.3%) had detectable micrometastases. The micrometastases were detected in the external iliac basin (two cases) and in the para-aortic area (two cases). The isolated tumor cell was detected in the external iliac basin (one case).Conclusion. SLNs detected by our method had micrometastases more frequently than did non-SLNs. Easy detection of micrometastases by immunostaining is only possible with step-serial sectioning of the SLNs. (c) 2007 Elsevier Inc. All rights reserved.