Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery

被引:153
作者
Motomura, K
Inaji, H
Komoike, Y
Kasugai, T
Nagumo, S
Noguchi, S
Koyama, H
机构
[1] Osaka Med Ctr Canc & Cardiovasc Dis, Dept Surg, Higashinari Ku, Osaka 5378511, Japan
[2] Osaka Med Ctr Canc & Cardiovasc Dis, Dept Pathol, Higashinari Ku, Osaka 5378511, Japan
[3] Osaka Med Ctr Canc & Cardiovasc Dis, Dept Cytol, Higashinari Ku, Osaka 5378511, Japan
[4] Osaka Univ, Sch Med, Dept Surg Oncol, Osaka, Japan
关键词
D O I
10.1046/j.1365-2168.2000.01423.x
中图分类号
R61 [外科手术学];
学科分类号
摘要
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.
引用
收藏
页码:597 / 601
页数:5
相关论文
共 30 条
[1]   Lymphatic mapping and sentinel node biopsy in the patient with breast cancer [J].
Albertini, JJ ;
Lyman, GH ;
Cox, C ;
Yeatman, T ;
Balducci, L ;
Ku, NN ;
Shivers, S ;
Berman, C ;
Wells, K ;
Rapaport, D ;
Shons, A ;
Horton, J ;
Greenberg, H ;
Nicosia, S ;
Clark, R ;
Cantor, A ;
Reintgen, DS .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1996, 276 (22) :1818-1822
[2]  
Bloustein P A, 1977, Pathol Annu, V12 Pt 2, P251
[3]   VALUE OF AXILLARY DISSECTION IN ADDITION TO LUMPECTOMY AND RADIOTHERAPY IN EARLY BREAST-CANCER [J].
CABANES, PA ;
SALMON, RJ ;
VILCOQ, JR ;
DURAND, JC ;
FOURQUET, A ;
GAUTIER, C ;
ASSELAIN, B .
LANCET, 1992, 339 (8804) :1245-1248
[4]   Guidelines for sentinel node biopsy and lymphatic mapping of patients with breast cancer [J].
Cox, CE ;
Pendas, S ;
Cox, JM ;
Joseph, E ;
Shons, AR ;
Yeatman, T ;
Ku, NN ;
Lyman, GH ;
Berman, C ;
Haddad, F ;
Reintgen, DS .
ANNALS OF SURGERY, 1998, 227 (05) :645-653
[5]   10-YEAR RESULTS OF A RANDOMIZED CLINICAL-TRIAL COMPARING RADICAL MASTECTOMY AND TOTAL MASTECTOMY WITH OR WITHOUT RADIATION [J].
FISHER, B ;
REDMOND, C ;
FISHER, ER ;
BAUER, M ;
WOLMARK, N ;
WICKERHAM, DL ;
DEUTSCH, M ;
MONTAGUE, E ;
MARGOLESE, R ;
FOSTER, R .
NEW ENGLAND JOURNAL OF MEDICINE, 1985, 312 (11) :674-681
[6]  
Flett MM, 1998, BRIT J SURG, V85, P991
[7]   Sentinel lymphadenectomy in breast cancer [J].
Giuliano, AE ;
Jones, RC ;
Brennan, M ;
Statman, R .
JOURNAL OF CLINICAL ONCOLOGY, 1997, 15 (06) :2345-2350
[8]   LYMPHATIC MAPPING AND SENTINEL LYMPHADENECTOMY FOR BREAST-CANCER [J].
GIULIANO, AE ;
KIRGAN, DM ;
GUENTHER, JM ;
MORTON, DL .
ANNALS OF SURGERY, 1994, 220 (03) :391-401
[9]  
GRAVERSEN HP, 1988, EUR J SURG ONCOL, V14, P407
[10]  
Greenberg RS., 1993, MED EPIDEMIOLOGY