Analysis of micrometastatic disease in sentinel lymph nodes from resectable colon cancer: Results of Cancer and Leukemia Group B trial 80001
Analysis of micrometastatic disease in sentinel lymph nodes from resectable colon cancer: Results of Cancer and Leukemia Group B trial 80001
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DOI：
10.1200/jco.2005.03.6038
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发表时间：
2006-02-20
影响因子：
45.3
通讯作者：
Bertagnolli, MM
中科院分区：
文献类型：
--
作者：
Redston, M;Compton, CC;Bertagnolli, MM
目的探讨前哨淋巴结（sentinel lymph node，LN）取样（sentinel lymph node sampling，SLNS）是否能减少结肠癌微转移灶（micrometastatic disease，MMD）的淋巴结数目。患者和方法癌症和白血病组B 80001是一项研究，以确定SLNS是否可以识别一个子集的LN，预测状态的淋巴结盆可切除的结肠癌，因此，可以广泛评估存在的微转移。入组本研究的患者接受SLNS注射后的1%异硫蓝，和前哨淋巴结（SN）和非SN在原发性肿瘤切除术中获得的切片在多个层面和染色使用抗癌胚抗原和anticytokeratin antibodies.Results使用标准的组织病理学，SN未能预测存在的淋巴结疾病的13（54%）的24个节点阳性patients。免疫组化染色的患者，其淋巴结是阴性的标准组织病理学。根据用于分配LN阳性的免疫组化标准，SN检查导致一个不可接受的高假阳性率（20%）或低敏感性检测MMD（40%）。结论通过检查SN和非SN，这个多机构的研究表明，SN并不能准确预测存在传统定义的淋巴结转移或MMD。因此，SLNS不是研究结肠癌患者MMD的有用技术。
Purpose To determine whether sentinel lymph node (LN) sampling (SLNS) could reduce the number of nodes required to characterize micrometastatic disease (MMD) in patients with potentially curable colon cancer. Patients andMethods Cancer and Leukemia Group B 80001 was a study to determine whether SLNS could identify a subset of LNs that predicted the status of the nodal basin for resectable colon cancer and, therefore, could be extensively evaluated for the presence of micrometastases. Patients enrolled onto this study underwent SLNS after injection of 1 % isosulfan blue, and both sentinel nodes (SNs) and non-SNs obtained during primary tumor resection were sectioned at multiple levels and stained using anti-carcinoembryonic antigen and anticytokeratin antibodies.Results Using standard histopathology, SNs failed to predict the presence of nodal disease in 13 (54%) of 24 node-positive patients. Immunostains were performed for patients whose LNs were negative by standard histopathology. Depending on the immunohistochemical criteria used to assign LN positivity, SN examination resulted in either an unacceptably high false-positive rate (20%) or a low sensitivity for detection of MMD (40%).Conclusion By examining both SNs and non-SNs, this multi-institutional study showed that SNs did not accurately predict the presence of either conventionally defined nodal metastases or MMD. As a result, SLNS is not a useful technique for the study of MMD in patients with colon cancer.