Prospective randomized study comparing sentinel lymph node evaluation with standard pathologic evaluation for the staging of colon carcinoma - Results from the United States Military Cancer Institute Clinical Trials Group study GI-01
Prospective randomized study comparing sentinel lymph node evaluation with standard pathologic evaluation for the staging of colon carcinoma - Results from the United States Military Cancer Institute Clinical Trials Group study GI-01
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DOI：
10.1097/01.sla.0000256390.13550.26
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发表时间：
2007-06-01
影响因子：
9
通讯作者：
Peoples, George E.
中科院分区：
文献类型：
--
作者：
Stojadinovic, Alexander;Nissan, Aviram;Peoples, George E.
背景：前哨淋巴结（SLN）取样和超分期在结肠癌中的主要作用是提高分期准确性。这项技术对结肠癌患者的实用性仍存在争议。 目的：这项多中心随机试验旨在确定，与传统组织病理学相比，采用分步切片和免疫组织化学 (IHC) 对 SLN 进行集中评估是否能增强对可切除结肠癌患者进行区域淋巴结盆地分期的能力。 患者和方法：2002 年 8 月至 2006 年 4 月期间，我们将 161 名 I-III 期结肠癌患者随机分配至标准组织病理学评估或SLN 定位（离体、浆膜下、肿瘤周围、1% 异硫蓝染料）和使用全细胞角蛋白 IHC 结合标准组织病理学进行超分期。 SLN 阳性疾病定义为通过苏木精和伊红 (H&E) 和/或 IHC 鉴定的单个肿瘤细胞或细胞聚集体。主要终点是淋巴结升期率。结果：SLN 超分期发现显着的淋巴结升期（对照 vs. SLN：38.7% vs. 57.3%，P = 0.019）。当 SLN 与细胞聚集时
Background: The principal role of sentinel lymph node (SLN) sampling and ultrastaging in colon cancer is enhanced staging accuracy. The utility of this technique for patients with colon cancer remains controversial.Purpose: This multicenter randomized trial was conducted to determine if focused assessment of the SLN with step sectioning and immunohistochemistry (IHC) enhances the ability to stage the regional nodal basin over conventional histopathology in patients with resectable colon cancer.Patients and Methods: Between August 2002 and April 2006 we randomly assigned 161 patients with stage I-III colon cancer to standard histopathologic evaluation or SLN mapping (ex vivo, subserosal, peritumoral, 1% isosulfan blue dye) and ultrastaging with pan-cytokeratin IHC in conjunction with standard histopathology. SLN-positive disease was defined as individual tumor cells or cell aggregates identified by hematoxylin and eosin (H&E) and/or IHC. Primary end point was the rate of nodal upstaging.Results: Significant nodal upstaging was identified with SLN ultrastaging (Control vs. SLN: 38.7% vs. 57.3%, P = 0.019). When SLNs with cell aggregates