Clinical significance of MSKCC nomogram on guiding the application of touch imprint cytology and frozen section in intraoperative assessment of breast sentinel lymph nodes.
Clinical significance of MSKCC nomogram on guiding the application of touch imprint cytology and frozen section in intraoperative assessment of breast sentinel lymph nodes.
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MSKCC列线图指导接触印迹细胞学和冰冻切片术中评估乳腺前哨淋巴结的临床意义
DOI：
10.18632/oncotarget.17490
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发表时间：
2017-09-29
期刊：
影响因子：
--
通讯作者：
Chen B
中科院分区：
文献类型：
--
作者：
Sun L;Chen G;Zhou Y;Zhang L;Jin Z;Liu W;Wu G;Jin F;Li K;Chen B
术中快速评估和检测前哨淋巴结（SLN）状态的常用方法包括冰冻切片（FS）和触摸印片细胞学（TIC）。本研究基于Memorial Sloan Kettering Cancer Center（MSKCC）列线图优化了TIC和FS在乳腺SLN术中检测中的使用。79例患者共取出SLN 342枚。用MSKCC列线图评估SLN转移概率。SLN进行术中TIC和FS，以及常规术后石蜡切片（RPS）。分析TIC、FS与SLN转移概率的关系。总的来说，TIC比FS更敏感（92.31% vs. 76.92%），而TIC特异性低于FS特异性（84.85% vs. 100%）。此外，基于MSKCC列线图的TIC最佳临界值劣于最佳FS临界值（22.5% vs. 34.5%）。MSKCC值<22.5%的患者FS和RPS均为阴性，而TIC的真阴性率和假阳性率分别为92.5%和7.5%。因此，基于MSKCC值<22.5%，早期乳腺癌患者可以安全地避免FS，但应在术中进行TIC。MSKCC值>22.5%的患者应进行TIC和FS，以确定转移灶的大小，是否进行腋窝淋巴结清扫，避免容易漏诊的转移灶。
The widely practiced intra-operative methods for rapid evaluation and detection of sentinel lymph node (SLN) status include frozen section (FS) and touch imprint cytology (TIC). This study optimized the use of TIC and FS in the intra-operative detection of breast SLNs based on the Memorial Sloan Kettering Cancer Center (MSKCC) nomogram. Three hundred forty-two SLNs were removed from 79 patients. SLN metastatic probability was assessed by the MSKCC nomogram. The SLNs underwent intra-operative TIC and FS, as well as routine post-operative paraffin sections (RPSs). The relationships between TIC, FS, and SLN metastatic probability were analyzed. Overall, TIC was more sensitive than FS (92.31% vs. 76.92%), while TIC specificity was inferior to FS specificity (84.85% vs. 100%). In addition, the best cut-off value for TIC based on the MSKCC nomogram was inferior to the best FS cut-off value (22.5% vs. 34.5%). All patients with a MSKCC value <22.5% in the present study were negative based on FS and RPS, while the true-negative and false-positive rates for TIC were 92.5% and 7.5%, respectively. Thus, early breast cancer patients, based on a MSKCC value <22.5%, can safely avoid FS, but should have TIC performed intra-operatively. Patients with a MSKCC value >22.5% should have TIC and FS to determine the size of metastases, whether or not to proceed with axillary lymph node dissection, and to avoid easily missed metastases.
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影响因子：
3.8
作者：
Chen, J. -J.;Chen, J. -Y.;Wu, J.
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