Intraoperative touch imprint of sentinel lymph nodes in breast carcinoma patients
Intraoperative touch imprint of sentinel lymph nodes in breast carcinoma patients
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DOI：
10.1002/cncr.10721
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发表时间：
2002-08-25
影响因子：
3.4
通讯作者：
Sneige, N
中科院分区：
文献类型：
--
作者：
Lee, A;Krishnamurthy, S;Sneige, N
背景乳腺癌患者的前哨淋巴结检查越来越受欢迎。目前，没有标准的术中评估前哨淋巴结。为了评估术中触摸印片（TI）评估的实用性，作者比较了乳腺癌患者前哨淋巴结的TI细胞学与表面苏木精和伊红（H&E）组织学。确定了65例前哨淋巴结活检病例。将TI和表面H&E组织切片的诊断进行比较。触诊法对前哨淋巴结活检的特异性为100%，阴性预测值为88%，敏感性为65%，假阴性率为9%。83%的假阴性TI病例是由于微转移引起的。术前化疗、原发肿瘤类型和原发肿瘤大小对假阴性事件无显著影响。触摸印记识别67%的病例需要完成腋窝清扫。触摸印记是一种可靠和准确的术中技术，有可能节省大量患者的发病率和第二次手术切除腋窝淋巴结的费用。识别微转移的困难似乎是假阴性事件的主要来源，这不是TI细胞学特有的问题。(C)2002年美国癌症协会。
BACKGROUND. Sentinel lymph node examination in patients with breast carcinoma has been gaining in popularity. Currently, there is no standard intraoperative assessment of sentinel lymph nodes. To assess the utility, of an intraoperative touch imprint (TI) evaluation, the authors compared TI cytology with surface hematoxylin and eosin (H&E) histology in sentinel lymph nodes from patients with breast carcinoma.METHODS. Sixty five sentinel lymph node biopsy cases were identified. Diagnoses from TI and surface H&E histologic sections were compared.RESULTS. Touch imprint had a specificity of 100%, a negative predictive value of 88%, a sensitivity of 65%, and a false negative rate of 9% per sentinel lymph node biopsy case. Eighty three percent of the false negative TI cases were due to micrometastasis. Preoperative chemotherapy, primary tumor type, and primary tumor size did not significantly contribute to false negative events. Touch imprint identified 67% of the cases that required completion axillary dissection.CONCLUSIONS. Touch imprint is a reliable and accurate intraoperative technique, with the potential to save a significant number of patients morbidity and the cost of a second surgical procedure to remove axillary lymph nodes. The difficulty of identifying micrometastases appeared to be the major source of false negative events, a problem that is not unique to TI cytology. (C) 2002 American Cancer Society.