Diagnostic criteria of sentinel lymph node micrometastasis or macrometastasis based on tissue rinse liquid-based cytology in gynecological cancer
Diagnostic criteria of sentinel lymph node micrometastasis or macrometastasis based on tissue rinse liquid-based cytology in gynecological cancer
复制标题
妇科癌症前哨淋巴结微转移或大转移的组织冲洗液细胞学诊断标准
DOI：
10.1007/s10147-020-01774-y
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发表时间：
2020
影响因子：
3.3
通讯作者：
K. Yamashiro
中科院分区：
文献类型：
--
作者：
H. Matsumiya;Y. Todo;H. Yamazaki;R. Yamada;K. Minowa;T. Tsuruta;H. Kurosu;S. Minobe;H. Kato;Hiroaki Suzuki;K. Taira;K. Yamashiro
目的本研究旨在建立妇科癌症术中基于组织冲洗液细胞学（TRLBC）的前哨淋巴结（SLN）微/大转移诊断标准。方法从490例SLN中筛选出214例妇科肿瘤患者，根据TRLBC快速诊断SLN转移。对于在细胞学检查中被分类为非典型细胞阳性的载玻片，我们计算了簇数（由三个或更多细胞组成的非典型细胞团）和单个细胞（除簇以外的非典型细胞）的数量。应用接受者操作特征（ROC）分析来确定预测SLN微/大转移的效率。结果在细胞学检查中，36张载玻片被分类为非典型细胞阳性，21张载玻片（4.3％）为真阳性，15张（3.1％）为假阳性，454张（92.6％）为真阴性。本研究中没有出现假阴性结果。在区分微转移/宏观转移与阴性/孤立肿瘤细胞时，簇数的 ROC 曲线下面积优于单细胞数的 ROC 曲线下面积（0.86 vs. 0.67，P= 0.032）。区分这两类的最佳簇数截止值为 5。 结论 TRLBC 是检测 SLN 转移作为术中快速诊断的高度敏感的替代方案。计算非典型细胞簇的数量可能有助于区分微/宏观转移与孤立的肿瘤细胞。
ObjectiveThis study aimed to establish intraoperative diagnostic criteria of sentinel lymph node (SLN) micro-/macrometastasis on the basis of tissue rinse liquid-based cytology (TRLBC) in gynecological cancer.MethodsWe enrolled 214 patients with gynecological cancer who underwent rapid diagnosis of SLN metastasis on the basis of TRLBC from a total of 490 SLNs. For slides that were classified as positive for atypical cells on cytological inspection, we counted the number of clusters (an atypical cell mass consisted of three or more cells) and the number of single cells (an atypical cell other than clusters). Receiver operating characteristic (ROC) analysis was applied to determine the efficiency of predicting SLN micro-/macrometastasis.ResultsOn cytological inspection, 36 slides were classified as positive for atypical cells, while 21 slides (4.3%) were true positive, 15 (3.1%) were false positive, and 454 (92.6%) were true negative. There were no false negative results in this study. The area under the ROC curve for the number of cluster was superior to that for the number of single cells for distinguishing micro-/macrometastasis from negative/isolated tumor cells (0.86 vs. 0.67,P= 0.032). The optimum cut-off value of the number of clusters was 5 for distinguishing these two categories.ConclusionsTRLBC is a highly sensitive alternative for detecting SLN metastasis as a rapid intraoperative diagnosis. Counting the number of atypical cell clusters might be useful for distinguishing micro-/macrometastasis from isolated tumor cells.