Factors influencing accuracy of axillary sentinel lymph node frozen section for breast cancer
Factors influencing accuracy of axillary sentinel lymph node frozen section for breast cancer
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DOI：
10.1016/j.amjsurg.2010.01.017
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发表时间：
2010-05-01
影响因子：
3
通讯作者：
Troxell, Megan L.
中科院分区：
文献类型：
--
作者：
Jensen, Amariek J.;Naik, Arpana M.;Troxell, Megan L.
背景：术中前哨淋巴结（SLN）冷冻切片（FS）指导乳腺癌患者立即腋窝淋巴结清扫。方法：检索1999年10月以来俄勒冈卫生与科学大学病理数据库中的SLN FS。至2009年1月1日。我们回顾了阳性病例的载玻片，并测量了转移的大小。结果：416例患者中，永久切片和免疫组化阳性129例（31%），FS一致79例，假阴性50例。准确度88%，灵敏度61%，特异性100%。小叶癌的FS准确率（76%）低于浸润性导管癌（88%）（P = 0.048）。结节大小不同，FS的准确率有显著差异。对于49例2-mm转移的肿瘤，准确率为90% （P < 0.0001）。结论：假阴性FS主要是未在FS取样的小结节性肿瘤沉积。虽然准确性较低，但SLN FS在小叶癌中仍然是有益的，而在导管原位癌中则不是。(C) 2010爱思唯尔公司版权所有。
BACKGROUND: Intraoperative sentinel lymph node (SLN) frozen section (FS) guides immediate axillary lymph node dissection in breast cancer patients.METHODS: The Oregon Health & Science University pathology database was searched for SLN FS From October 1999. to January 1, 2009. Slides of positive cases were reviewed and metastasis sizes measured.RESULTS: Of 416 cases, 129 were positive (31%) on permanent sections and immunohistochemistry, with 79 concordant and 50 false-negative FS. Accuracy was 88%, sensitivity 61%, and specificity 100%. FS accuracy for lobular carcinoma (76%) was lower than for invasive ductal carcinoma (88%) (P = .048). FS accuracy significantly differed by size of nodal tumor. For 49 cases of tumor 2-mm metastases, accuracy was 90% (P < .0001).CONCLUSIONS: False-negative FS were predominantly small nodal tumor deposits not sampled at FS. Although accuracy was lower, SLN FS is still beneficial in lobular carcinoma, but not ductal carcinoma in situ. (C) 2010 Elsevier Inc. All rights reserved.