Intraoperative diagnosis of lymph node metastasis during segmentectomy for non-small cell lung cancer by rapid immunohistochemistry using noncontact alternating current electric field mixing.
Intraoperative diagnosis of lymph node metastasis during segmentectomy for non-small cell lung cancer by rapid immunohistochemistry using noncontact alternating current electric field mixing.
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DOI：
10.1111/1759-7714.13699
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发表时间：
2020-12
期刊：
影响因子：
2.9
通讯作者：
Minamiya Y
中科院分区：
文献类型：
--
作者：
Imai K;Nanjo H;Takashima S;Hiroshima Y;Atari M;Matsuo T;Kuriyama S;Ishii Y;Wakamatsu Y;Sato Y;Motoyama S;Saito H;Nomura K;Minamiya Y
虽然肺叶切除术被认为是任何非小细胞肺癌（NSCLC）的标准手术，但最近的证据表明，对于早期NSCLC，肺段切除术可能同样有效。然而，为了使肺段切除术在肿瘤学上安全，充分的术中淋巴结分期是必不可少的。本研究的目的是比较新型快速IHC系统与HE分析的结果，用于考虑行肺段切除术的肺癌患者的术中淋巴结诊断。这项回顾性研究分析了2014年至2020年6年期间NSCLC切除术的病理报告。使用一种新的快速IHC设备，我们施加了一个高压，低频交流（AC）场，随着电压的打开/关闭，它混合了抗泛细胞角蛋白抗体。快速免疫组化可在20分钟内提供淋巴结诊断。术中评估70例患者106个切除淋巴结的冷冻切片是否存在转移。其中，根据HE染色和快速IHC，5个淋巴结被视为阳性。此外，仅快速IHC在一个肺门淋巴结中检测到分离的肿瘤细胞。3例经HE染色和快速IHC检测到淋巴结转移的cStage IA患者接受了完全肺叶切除术。接受快速IHC肺段切除术的患者的5年无复发生存率和总生存率分别为88.77%和88.79%。由AC混合驱动的快速免疫组化简单、高度准确，并为后续检测保留了淋巴结组织。该系统可有效地用于术中淋巴结诊断。基于交流电场混合的快速免疫组织化学（20分钟内完成）简单且高度准确。该系统将帮助临床医生在术中诊断淋巴结转移和决定适当的外科手术在肺段切除术。由交流电场混合驱动的快速免疫组织化学（在术中20分钟内完成）简单、高度准确，并保留淋巴结组织用于后续病理学检查，包括分子评估。肺段切除术治疗肺癌在肿瘤学上是安全的，但前提是术中有足够的淋巴结分期。快速免疫组化将有助于临床医生在术中淋巴结诊断。 基于交流电场混合的快速免疫组织化学（20分钟内完成）简单且高度准确。该系统将协助临床医生进行淋巴结转移的术中诊断并在肺癌肺段切除术中决定适当的外科手术。
Although lobectomy is considered the standard surgery for any non‐small cell lung cancer (NSCLC), recent evidence indicates that for early NSCLCs segmentectomy may be equally effective. For segmentectomy to be oncologically safe, however, adequate intraoperative lymph node staging is essential. The aim of this study was to compare the results of a new rapid‐IHC system to the HE analysis for intraoperative nodal diagnosis in lung cancer patients considered for segmentectomy. This retrospective study analyzed the pathological reports from NSCLC resections over a six‐year period between 2014 and 2020. Using a new device for rapid‐IHC, we applied a high‐voltage, low‐frequency alternating current (AC) field, which mixes the antipancytokeratin antibody as the voltage is switched on/off. Rapid‐IHC can provide a nodal diagnosis within 20 minutes. Frozen sections from 106 resected lymph nodes from 70 patients were intraoperatively evaluated for metastasis. Of those, five nodes were deemed positive based on both HE staining and rapid‐IHC. In addition, rapid‐IHC alone detected isolated tumor cells in one hilar lymph node. Three cStage IA patients with nodal metastasis detected with HE staining and rapid‐IHC received complete lobectomies. Five‐year relapse‐free survival and overall survival among patients receiving segmentectomy with rapid‐IHC were 88.77% and 88.79%, respectively. Rapid‐IHC driven by AC mixing is simple, highly accurate, and preserves nodal tissue for subsequent tests. This system can be used effectively for intraoperative nodal diagnosis. Rapid immunohistochemistry based on alternating‐current field mixing (completed within 20 minutes) is simple and highly accurate. This system will assist clinicians when making intraoperative diagnoses of lymph node metastasis and deciding upon the appropriate surgical procedure in segmentectomy for lung cancer. Rapid immunohistochemistry driven by alternating‐current field mixing (completed within 20 minutes intraoperatively) is simple, highly accurate, and preserves lymph node tissue for subsequent pathological examination, including molecular assessments. Segmentectomy for lung cancer is oncologically safe, but only when there is adequate intraoperative node staging. Rapid immunohistochemistry will assist clinicians when making intraoperative nodal diagnoses. Rapid immunohistochemistry based on alternating‐current field mixing (completed within 20 minutes) is simple and highly accurate. This system will assist clinicians when making intraoperative diagnoses of lymph node metastasis and deciding upon the appropriate surgical procedure in segmentectomy for lung cancer.
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影响因子：
51.1
作者：
Chang, Joe Y.;Senan, Suresh;Paul, Marinus A.;Mehran, Reza J.;Louie, Alexander V.;Balter, Peter;Groen, Harry J. M.;McRae, Stephen E.;Widder, Joachim;Feng, Lei;van den Borne, Ben E. E. M.;Munsell, Mark F.;Hurkmans, Coen;Berry, Donald A.;van Werkhoven, Erik;Kresl, John J.;Dingemans, Anne-Marie;Dawood, Omar;Haasbeek, Cornelis J. A.;Carpenter, Larry S.;De Jaeger, Katrien;Komaki, Ritsuko;Slotman, Ben J.;Smit, Egbert F.;Roth, Jack A.
通讯作者：
Roth, Jack A.
影响因子：
6
作者：
Koike, T;Yamato, Y;Suzuki, R
通讯作者：
Suzuki, R
影响因子：
3.4
作者：
Inoue, Masayoshi;Minami, Masato;Okumura, Meinoshin
通讯作者：
Okumura, Meinoshin
影响因子：
45.3
作者：
Landreneau, Rodney J.;Normolle, Daniel P.;Schuchert, Matthew J.
通讯作者：
Schuchert, Matthew J.
影响因子：
5.3
作者：
Inoue, Masayoshi;Hiyama, Kayo;Okumura, Meinoshin
通讯作者：
Okumura, Meinoshin