Histopathological validation of the sentinel node concept in cervical cancer
Histopathological validation of the sentinel node concept in cervical cancer
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DOI：
10.1093/annonc/mdh227
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发表时间：
2004-06-01
影响因子：
50.5
通讯作者：
Callard, P
中科院分区：
文献类型：
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作者：
Barranger, E;Cortez, A;Callard, P
背景：前哨淋巴结（SN）被定义为淋巴系统引流肿瘤部位的第一个淋巴结。如果SN没有转移，那么所有其他淋巴结也应该无病。我们使用连续切片和免疫组化（IHC）染色来检查前哨淋巴结和非前哨淋巴结（non-SNs）。材料与方法：2001年7月至2003年3月，18例宫颈癌患者（IA2期1例，113期9例，1132期3例，IIA期3例，1113期2例）采用联合检测方法行腹腔镜下盆腔淋巴结清扫术，术后行腹腔镜盆腔淋巴结清扫术。如果苏木精和伊红（H&E）和免疫组化染色均未发现SN转移，则采用联合染色法检查所有非SN。结果：每位患者平均切除2.4个SNs（范围1-5）和8个非SNs（范围4-14）。5例（27.8%）患者的8例（18.2%）淋巴结转移，包括2例大转移性淋巴结、3例微转移性淋巴结和3例分离的肿瘤细胞。在13例患者中，H&E和IHC染色未检测到转移性SN浸润。在这13例患者中，106例非sns通过连续切片和免疫组化检查，均未发现转移。结论：SN手术似乎可以可靠地预测宫颈癌患者局部淋巴池的转移状态。
Background: The sentinel node (SN) is defined as the first node in the lymphatic system that drains a tumor site. If the SN is not metastatic, then all other nodes should also be disease-free. We used serial sections and immunohistochemical (IHC) staining to examine both sentinel and non-sentinel nodes (non-SNs).Materials and methods: From July 2001 to March 2003, 18 patients (median age, 48 years) with cervical cancer (stage IA2, one patient; stage 113 1, nine patients; stage 1132, three patients; stage IIA, three patients; and stage 1113, two patients) underwent a laparoscopic SN procedure based on a combined detection method, followed by complete laparoscopic pelvic lymphadenectomy. If the SN was free of metastasis by both hematoxylin and eosin (H&E) and IHC staining, all non-SNs were also examined by the combined staining method.Results: A mean of 2.4 SNs (range 1-5) and 8 non-SNs (range 4-14) were excised per patient. Eight SNs (18.2%) from five patients (27.8%) were found to be metastatic at the final histological assessment, including two macrometastatic SNs, three micrometastatic SNs and isolated tumor cells in three SNs. In 13 patients, no metastatic SN involvement was detected by H&E and IHC staining. In these 13 patients, 106 non-SNs were examined by serial sectioning and IHC, and none was found to be metastatic.Conclusions: The SN procedure appears to reliably predict the metastatic status of the regional lymphatic basin in patients with cervical cancer.