Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery
Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery
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DOI：
10.1046/j.1365-2168.2000.01423.x
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发表时间：
2000-05-01
影响因子：
9.6
通讯作者：
Koyama, H
中科院分区：
文献类型：
--
作者：
Motomura, K;Inaji, H;Koyama, H
背景资料：本研究的目的是评估术中印片细胞学和前哨淋巴结的冷冻切片的临床淋巴结阴性breastcancer.Methods：前哨淋巴结活检的实用性进行了101例临床阴性淋巴结的I期或II期乳腺癌患者使用染料引导的方法。术中评估前哨淋巴结受累的印片细胞学和冷冻切片进行了比较，与最终的组织病理学结果的永久部分。苏木精和伊红染色的石蜡切片中的肿瘤阴性的节点进行了进一步研究，使用anticytokeratin antibody.Results：印片细胞学和冰冻切片分析的结果进行了比较与苏木精和伊红染色的切片。印片细胞学检查的敏感性、特异性和总体准确性分别为96.0%、90.8%和92.1%，冰冻切片检查的敏感性、特异性和总体准确性分别为52.0%、100%和88.1%。免疫组化发现8个淋巴结有微转移。考虑到这些免疫组化结果，最终的敏感性，特异性和总体准确性的印片细胞学分别为90.9%，98.5%和96.0%forecast.Conclusion：术中印片细胞学是一种有用的方法，用于评估前哨淋巴结的状态，是比冷冻切片分析更准确。此外，印片细胞学可以检测微转移更准确地比传统的苏木精和伊红染色切片。
Background: The purpose of the present study was to evaluate the usefulness of intraoperative imprint cytology and frozen sectioning of sentinel lymph nodes in patients with clinically node-negative breast cancer.Methods: Sentinel node biopsy was performed in 101 patients with stage I or II breast cancer with clinically negative nodes using a dye-guided method. Intraoperative evaluation of sentinel node involvement by imprint cytology and frozen sectioning was compared with the final histopathological results of permanent sections. Tumour-negative nodes in paraffin sections stained by haematoxylin and eosin were further studied using an anticytokeratin antibody.Results: The results of imprint cytology and frozen-section analysis were compared with those of haematoxylin and eosin-stained sections. The sensitivity, specificity and overall accuracy of imprint cytology were 96.0, 90.8 and 92.1 per cent respectively, and those of frozen-section examination were 52.0, 100 and 88.1 per cent. Ten sentinel nodes were tumour positive on imprint cytology and tumour negative on stained paraffin sections. Micrometastasis was found in eight of these nodes on immunohistochemistry. Taking these immunohistological results into consideration, the final sensitivity, specificity and overall accuracy of imprint cytology were 90.9, 98.5 and 96.0 per cent respectively.Conclusion: Intraoperative imprint cytology is a useful method for evaluating the status of sentinel nodes and is more accurate than frozen-section analysis. In addition, imprint cytology can detect micrometastasis more accurately than conventional haematoxylin and eosin-stained sectioning.