Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer
Identifieur interne : 004D23 ( Istex/Corpus ); précédent : 004D22; suivant : 004D24Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer
Auteurs : Young Jin Choi ; Hae Ran Yun ; Ki Eun Yoo ; Jung Han Kim ; Seok Jin Nam ; Yoon La Choi ; Young Hyeh Ko ; Byung Tae Kim ; Jung-Hyun YangSource :
- Japanese Journal of Clinical Oncology [ 0368-2811 ] ; 2006-08.
English descriptors
Abstract
Background: The ultrarapid immunohistochemistry (IHC) technique was applied to the intraoperative examination of sentinel lymph nodes (SLNs) because routine SLN frozen section examinations sometimes produce false-negative results. The present study was undertaken to develop a reliable protocol for the ultrarapid IHC of SLNs. Methods: SLNs from 79 breast cancer patients with clinically negative axillary node were examined intraoperatively by frozen hematoxylin–eosin (H&E) stain and by ultrarapid cytokeratin IHC assay. On the basis of the result of serially sectioned permanent study, the sensitivity and accuracy of each intraoperative technique were compared. Results: The total number of dissected SLNs was 178 with a mean of 2.3 (1–5) per patient. The mean turnaround time for ultrarapid IHC was 20 min. The sensitivity rates of frozen H&E staining and ultrarapid IHC were 70.0 and 85.0%, respectively (P = 0.083). Each method had a specificity of 100%. The accuracy rates for frozen H&E staining and rapid IHC were 92.4 and 96.2%, respectively (P = 0.083). Ultrarapid IHC detected one additional patient with sentinel node micrometastasis and two additional patients with isolated tumor cells (ITCs). In those patients, two underwent completion axillary dissection simultaneously and could avoid a second operation. Conclusions: Ultrarapid cytokeratin IHC enhanced the intraoperative detection of sentinel node micrometastasis and ITCs in breast cancer without consuming much time. In patients who need completion axillary dissection after sentinel node biopsy, this technique could be helpful in avoiding a second operation.
Url:
DOI: 10.1093/jjco/hyl045
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ISTEX:A44D271A98F9C007DB6CA407F508CAFFB19D83DCLe document en format XML
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Yoo</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Kim, Jung Han" sort="Kim, Jung Han" uniqKey="Kim J" first="Jung Han" last="Kim">Jung Han Kim</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Nam, Seok Jin" sort="Nam, Seok Jin" uniqKey="Nam S" first="Seok Jin" last="Nam">Seok Jin Nam</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Choi, Yoon La" sort="Choi, Yoon La" uniqKey="Choi Y" first="Yoon La" last="Choi">Yoon La Choi</name><affiliation><mods:affiliation>Pathology and</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Ko, Young Hyeh" sort="Ko, Young Hyeh" uniqKey="Ko Y" first="Young Hyeh" last="Ko">Young Hyeh Ko</name><affiliation><mods:affiliation>Pathology and</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Kim, Byung Tae" sort="Kim, Byung Tae" uniqKey="Kim B" first="Byung Tae" last="Kim">Byung Tae Kim</name><affiliation><mods:affiliation>Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Yang, Jung Hyun" sort="Yang, Jung Hyun" uniqKey="Yang J" first="Jung-Hyun" last="Yang">Jung-Hyun Yang</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments 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of</mods:affiliation></affiliation></author><author><name sortKey="Yun, Hae Ran" sort="Yun, Hae Ran" uniqKey="Yun H" first="Hae Ran" last="Yun">Hae Ran Yun</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Yoo, Ki Eun" sort="Yoo, Ki Eun" uniqKey="Yoo K" first="Ki Eun" last="Yoo">Ki Eun Yoo</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Kim, Jung Han" sort="Kim, Jung Han" uniqKey="Kim J" first="Jung Han" last="Kim">Jung Han Kim</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Nam, Seok Jin" sort="Nam, Seok Jin" uniqKey="Nam S" first="Seok Jin" last="Nam">Seok Jin Nam</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Choi, Yoon La" sort="Choi, Yoon La" uniqKey="Choi Y" first="Yoon La" last="Choi">Yoon La Choi</name><affiliation><mods:affiliation>Pathology and</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Ko, Young Hyeh" sort="Ko, Young Hyeh" uniqKey="Ko Y" first="Young Hyeh" last="Ko">Young Hyeh Ko</name><affiliation><mods:affiliation>Pathology and</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Kim, Byung Tae" sort="Kim, Byung Tae" uniqKey="Kim B" first="Byung Tae" last="Kim">Byung Tae Kim</name><affiliation><mods:affiliation>Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author><author><name sortKey="Yang, Jung Hyun" sort="Yang, Jung Hyun" uniqKey="Yang J" first="Jung-Hyun" last="Yang">Jung-Hyun Yang</name><affiliation><mods:affiliation>Surgery,</mods:affiliation></affiliation><affiliation><mods:affiliation>Departments of</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Japanese Journal of Clinical Oncology</title><title level="j" type="abbrev">JJCO</title><idno type="ISSN">0368-2811</idno><idno type="eISSN">1465-3621</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2006-08">2006-08</date><biblScope unit="volume">36</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="489">489</biblScope><biblScope unit="page" to="493">493</biblScope></imprint><idno type="ISSN">0368-2811</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0368-2811</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>breast cancer</term><term>micrometastasis</term><term>sentinel lymph node</term><term>ultrarapid immunohistochemistry (IHC)</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: The ultrarapid immunohistochemistry (IHC) technique was applied to the intraoperative examination of sentinel lymph nodes (SLNs) because routine SLN frozen section examinations sometimes produce false-negative results. The present study was undertaken to develop a reliable protocol for the ultrarapid IHC of SLNs. Methods: SLNs from 79 breast cancer patients with clinically negative axillary node were examined intraoperatively by frozen hematoxylin–eosin (H&E) stain and by ultrarapid cytokeratin IHC assay. On the basis of the result of serially sectioned permanent study, the sensitivity and accuracy of each intraoperative technique were compared. Results: The total number of dissected SLNs was 178 with a mean of 2.3 (1–5) per patient. The mean turnaround time for ultrarapid IHC was 20 min. The sensitivity rates of frozen H&E staining and ultrarapid IHC were 70.0 and 85.0%, respectively (P = 0.083). Each method had a specificity of 100%. The accuracy rates for frozen H&E staining and rapid IHC were 92.4 and 96.2%, respectively (P = 0.083). Ultrarapid IHC detected one additional patient with sentinel node micrometastasis and two additional patients with isolated tumor cells (ITCs). In those patients, two underwent completion axillary dissection simultaneously and could avoid a second operation. Conclusions: Ultrarapid cytokeratin IHC enhanced the intraoperative detection of sentinel node micrometastasis and ITCs in breast cancer without consuming much time. In patients who need completion axillary dissection after sentinel node biopsy, this technique could be helpful in avoiding a second operation.</div></front></TEI><istex><corpusName>oup</corpusName><keywords><teeft><json:string>node</json:string><json:string>ultrarapid</json:string><json:string>axillary</json:string><json:string>micrometastasis</json:string><json:string>intraoperative</json:string><json:string>cytokeratin</json:string><json:string>metastasis</json:string><json:string>breast cancer</json:string><json:string>slns</json:string><json:string>sentinel</json:string><json:string>surg</json:string><json:string>metastatic</json:string><json:string>second operation</json:string><json:string>itcs</json:string><json:string>intraoperatively</json:string><json:string>ultrarapid cytokeratin</json:string><json:string>completion axillary dissection</json:string><json:string>lymph</json:string><json:string>breast carcinoma</json:string><json:string>sentinel lymph nodes</json:string><json:string>sentinel node</json:string><json:string>breast cancer patients</json:string><json:string>axillary dissection</json:string><json:string>sentinel node biopsy</json:string><json:string>carcinoma</json:string><json:string>biopsy</json:string><json:string>intraoperative examination</json:string><json:string>intraoperative detection</json:string><json:string>present study</json:string><json:string>tumor cells</json:string><json:string>tumor size</json:string><json:string>ultrarapid immunohistochemistry</json:string><json:string>serial sections</json:string><json:string>axillary lymph nodes</json:string><json:string>sentinel node metastasis</json:string><json:string>clinical significance</json:string><json:string>sentinel node micrometastasis</json:string><json:string>dissection</json:string></teeft></keywords><author><json:item><name>Young Jin Choi</name><affiliations><json:string>Surgery,</json:string><json:string>Departments of</json:string></affiliations></json:item><json:item><name>Hae Ran Yun</name><affiliations><json:string>Surgery,</json:string><json:string>Departments of</json:string></affiliations></json:item><json:item><name>Ki Eun Yoo</name><affiliations><json:string>Surgery,</json:string><json:string>Departments of</json:string></affiliations></json:item><json:item><name>Jung Han Kim</name><affiliations><json:string>Surgery,</json:string><json:string>Departments of</json:string></affiliations></json:item><json:item><name>Seok Jin Nam</name><affiliations><json:string>Surgery,</json:string><json:string>Departments of</json:string></affiliations></json:item><json:item><name>Yoon La Choi</name><affiliations><json:string>Pathology and</json:string><json:string>Departments of</json:string></affiliations></json:item><json:item><name>Young Hyeh Ko</name><affiliations><json:string>Pathology and</json:string><json:string>Departments of</json:string></affiliations></json:item><json:item><name>Byung Tae Kim</name><affiliations><json:string>Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</json:string><json:string>Departments of</json:string></affiliations></json:item><json:item><name>Jung-Hyun Yang</name><affiliations><json:string>Surgery,</json:string><json:string>Departments of</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>breast cancer</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>micrometastasis</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>sentinel lymph node</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>ultrarapid immunohistochemistry (IHC)</value></json:item></subject><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background: The ultrarapid immunohistochemistry (IHC) technique was applied to the intraoperative examination of sentinel lymph nodes (SLNs) because routine SLN frozen section examinations sometimes produce false-negative results. The present study was undertaken to develop a reliable protocol for the ultrarapid IHC of SLNs. Methods: SLNs from 79 breast cancer patients with clinically negative axillary node were examined intraoperatively by frozen hematoxylin–eosin (H&E) stain and by ultrarapid cytokeratin IHC assay. On the basis of the result of serially sectioned permanent study, the sensitivity and accuracy of each intraoperative technique were compared. Results: The total number of dissected SLNs was 178 with a mean of 2.3 (1–5) per patient. The mean turnaround time for ultrarapid IHC was 20 min. The sensitivity rates of frozen H&E staining and ultrarapid IHC were 70.0 and 85.0%, respectively (P = 0.083). Each method had a specificity of 100%. The accuracy rates for frozen H&E staining and rapid IHC were 92.4 and 96.2%, respectively (P = 0.083). Ultrarapid IHC detected one additional patient with sentinel node micrometastasis and two additional patients with isolated tumor cells (ITCs). In those patients, two underwent completion axillary dissection simultaneously and could avoid a second operation. Conclusions: Ultrarapid cytokeratin IHC enhanced the intraoperative detection of sentinel node micrometastasis and ITCs in breast cancer without consuming much time. In patients who need completion axillary dissection after sentinel node biopsy, this technique could be helpful in avoiding a second operation.</abstract><qualityIndicators><score>7.808</score><pdfVersion>1.4</pdfVersion><pdfPageSize>596.402 x 795.819 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1634</abstractCharCount><pdfWordCount>2976</pdfWordCount><pdfCharCount>19210</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>236</abstractWordCount></qualityIndicators><title>Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer</title><genre><json:string>research-article</json:string></genre><host><title>Japanese Journal of Clinical Oncology</title><language><json:string>unknown</json:string></language><issn><json:string>0368-2811</json:string></issn><eissn><json:string>1465-3621</json:string></eissn><publisherId><json:string>jjco</json:string></publisherId><volume>36</volume><issue>8</issue><pages><first>489</first><last>493</last></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>oncology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>oncology & carcinogenesis</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string><json:string>tumeurs</json:string></inist></categories><publicationDate>2006</publicationDate><copyrightDate>2006</copyrightDate><doi><json:string>10.1093/jjco/hyl045</json:string></doi><id>A44D271A98F9C007DB6CA407F508CAFFB19D83DC</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/A44D271A98F9C007DB6CA407F508CAFFB19D83DC/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/A44D271A98F9C007DB6CA407F508CAFFB19D83DC/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/A44D271A98F9C007DB6CA407F508CAFFB19D83DC/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Oxford University Press</publisher><availability><p>© 2006 Foundation for Promotion of Cancer Research</p></availability><date>2006-06-20</date></publicationStmt><notesStmt><note>For reprints and all correspondence: Jung-Hyun Yang, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Gangnam-gu, Seoul 135-710, Korea. E-mail: jhyang@smc.samsung.co.kr</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer</title><author xml:id="author-0000"><persName><forename type="first">Young Jin</forename><surname>Choi</surname></persName><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Hae Ran</forename><surname>Yun</surname></persName><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Ki Eun</forename><surname>Yoo</surname></persName><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Jung Han</forename><surname>Kim</surname></persName><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Seok Jin</forename><surname>Nam</surname></persName><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Yoon La</forename><surname>Choi</surname></persName><affiliation>Pathology and</affiliation><affiliation>Departments of</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Young Hyeh</forename><surname>Ko</surname></persName><affiliation>Pathology and</affiliation><affiliation>Departments of</affiliation></author><author xml:id="author-0007"><persName><forename type="first">Byung Tae</forename><surname>Kim</surname></persName><affiliation>Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><affiliation>Departments of</affiliation></author><author xml:id="author-0008"><persName><forename type="first">Jung-Hyun</forename><surname>Yang</surname></persName><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation></author><idno type="istex">A44D271A98F9C007DB6CA407F508CAFFB19D83DC</idno><idno type="DOI">10.1093/jjco/hyl045</idno><idno type="local">hyl045</idno></analytic><monogr><title level="j">Japanese Journal of Clinical Oncology</title><title level="j" type="abbrev">JJCO</title><idno type="pISSN">0368-2811</idno><idno type="eISSN">1465-3621</idno><idno type="PublisherID">jjco</idno><idno type="PublisherID-hwp">jjco</idno><idno type="PublisherID-nlm-ta">Jpn J Clin Oncol</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2006-08"></date><biblScope unit="volume">36</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="489">489</biblScope><biblScope unit="page" to="493">493</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2006-06-20</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background: The ultrarapid immunohistochemistry (IHC) technique was applied to the intraoperative examination of sentinel lymph nodes (SLNs) because routine SLN frozen section examinations sometimes produce false-negative results. The present study was undertaken to develop a reliable protocol for the ultrarapid IHC of SLNs. Methods: SLNs from 79 breast cancer patients with clinically negative axillary node were examined intraoperatively by frozen hematoxylin–eosin (H&E) stain and by ultrarapid cytokeratin IHC assay. On the basis of the result of serially sectioned permanent study, the sensitivity and accuracy of each intraoperative technique were compared. Results: The total number of dissected SLNs was 178 with a mean of 2.3 (1–5) per patient. The mean turnaround time for ultrarapid IHC was 20 min. The sensitivity rates of frozen H&E staining and ultrarapid IHC were 70.0 and 85.0%, respectively (P = 0.083). Each method had a specificity of 100%. The accuracy rates for frozen H&E staining and rapid IHC were 92.4 and 96.2%, respectively (P = 0.083). Ultrarapid IHC detected one additional patient with sentinel node micrometastasis and two additional patients with isolated tumor cells (ITCs). In those patients, two underwent completion axillary dissection simultaneously and could avoid a second operation. Conclusions: Ultrarapid cytokeratin IHC enhanced the intraoperative detection of sentinel node micrometastasis and ITCs in breast cancer without consuming much time. In patients who need completion axillary dissection after sentinel node biopsy, this technique could be helpful in avoiding a second operation.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>KWD</head><item><term>breast cancer</term></item><item><term>micrometastasis</term></item><item><term>sentinel lymph node</term></item><item><term>ultrarapid immunohistochemistry (IHC)</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2006-06-20">Created</change><change when="2006-08">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/A44D271A98F9C007DB6CA407F508CAFFB19D83DC/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup, element #text not found" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="US-ASCII"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article xml:lang="en" article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jjco</journal-id><journal-id journal-id-type="nlm-ta">Jpn J Clin Oncol</journal-id>
<journal-id journal-id-type="publisher-id">jjco</journal-id><journal-title>Japanese Journal of Clinical Oncology</journal-title><abbrev-journal-title abbrev-type="publisher">JJCO</abbrev-journal-title><issn pub-type="ppub">0368-2811</issn><issn pub-type="epub">1465-3621</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="other">hyl045</article-id><article-id pub-id-type="doi">10.1093/jjco/hyl045</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer</article-title></title-group><contrib-group>
<contrib contrib-type="author"><name><surname>Choi</surname><given-names>Young Jin</given-names></name>
<xref rid="AFF1">1</xref>
</contrib><contrib contrib-type="author"><name><surname>Yun</surname><given-names>Hae Ran</given-names></name>
<xref rid="AFF1">1</xref>
</contrib><contrib contrib-type="author"><name><surname>Yoo</surname><given-names>Ki Eun</given-names></name>
<xref rid="AFF1">1</xref>
</contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Jung Han</given-names></name>
<xref rid="AFF1">1</xref>
</contrib><contrib contrib-type="author"><name><surname>Nam</surname><given-names>Seok Jin</given-names></name>
<xref rid="AFF1">1</xref>
</contrib><contrib contrib-type="author"><name><surname>Choi</surname><given-names>Yoon La</given-names></name>
<xref rid="AFF2">2</xref>
</contrib><contrib contrib-type="author"><name><surname>Ko</surname><given-names>Young Hyeh</given-names></name>
<xref rid="AFF2">2</xref>
</contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Byung Tae</given-names></name>
<xref rid="AFF3">3</xref>
</contrib><contrib contrib-type="author"><name><surname>Yang</surname><given-names>Jung-Hyun</given-names></name>
<xref rid="AFF1">1</xref>
</contrib><aff>Departments of <target target-type="aff" id="AFF1"></target><label>1</label>Surgery, <target target-type="aff" id="AFF2"></target><label>2</label>Pathology and <target target-type="aff" id="AFF3"></target><label>3</label>Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</aff></contrib-group><author-notes><corresp>For reprints and all correspondence: Jung-Hyun Yang, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Gangnam-gu, Seoul 135-710, Korea. E-mail: <ext-link xlink:href="jhyang@smc.samsung.co.kr" ext-link-type="email">jhyang@smc.samsung.co.kr</ext-link></corresp></author-notes><pub-date pub-type="epub"><day>20</day><month>6</month><year>2006</year></pub-date><pub-date pub-type="ppub"><month>August</month><year>2006</year></pub-date><volume>36</volume><issue>8</issue><fpage>489</fpage><lpage>493</lpage><history><date date-type="accepted"><day>14</day><month>4</month><year>2006</year></date><date date-type="received"><day>19</day><month>1</month><year>2006</year></date></history><permissions><copyright-statement>© 2006 Foundation for Promotion of Cancer Research</copyright-statement><copyright-year>2006</copyright-year></permissions><abstract xml:lang="en">
<p><bold>Background:</bold> The ultrarapid immunohistochemistry (IHC) technique was applied to the intraoperative examination of sentinel lymph nodes (SLNs) because routine SLN frozen section examinations sometimes produce false-negative results. The present study was undertaken to develop a reliable protocol for the ultrarapid IHC of SLNs.</p>
<p><bold>Methods:</bold> SLNs from 79 breast cancer patients with clinically negative axillary node were examined intraoperatively by frozen hematoxylin–eosin (H&E) stain and by ultrarapid cytokeratin IHC assay. On the basis of the result of serially sectioned permanent study, the sensitivity and accuracy of each intraoperative technique were compared.</p>
<p><bold>Results:</bold> The total number of dissected SLNs was 178 with a mean of 2.3 (1–5) per patient. The mean turnaround time for ultrarapid IHC was 20 min. The sensitivity rates of frozen H&E staining and ultrarapid IHC were 70.0 and 85.0%, respectively (<italic>P</italic> = 0.083). Each method had a specificity of 100%. The accuracy rates for frozen H&E staining and rapid IHC were 92.4 and 96.2%, respectively (<italic>P</italic> = 0.083). Ultrarapid IHC detected one additional patient with sentinel node micrometastasis and two additional patients with isolated tumor cells (ITCs). In those patients, two underwent completion axillary dissection simultaneously and could avoid a second operation.</p>
<p><bold>Conclusions:</bold> Ultrarapid cytokeratin IHC enhanced the intraoperative detection of sentinel node micrometastasis and ITCs in breast cancer without consuming much time. In patients who need completion axillary dissection after sentinel node biopsy, this technique could be helpful in avoiding a second operation.</p>
</abstract><kwd-group kwd-group-type="KWD" xml:lang="en">
<kwd>breast cancer</kwd>
<kwd>micrometastasis</kwd>
<kwd>sentinel lymph node</kwd>
<kwd>ultrarapid immunohistochemistry (IHC)</kwd>
</kwd-group><custom-meta-wrap><custom-meta><meta-name>hwp-legacy-fpage</meta-name><meta-value>489</meta-value></custom-meta><custom-meta><meta-name>cover-date</meta-name><meta-value>August 2006</meta-value></custom-meta><custom-meta><meta-name>hwp-legacy-dochead</meta-name><meta-value>Original Article</meta-value></custom-meta></custom-meta-wrap></article-meta></front>
</article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer</title></titleInfo><name type="personal"><namePart type="given">Young Jin</namePart><namePart type="family">Choi</namePart><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hae Ran</namePart><namePart type="family">Yun</namePart><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ki Eun</namePart><namePart type="family">Yoo</namePart><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jung Han</namePart><namePart type="family">Kim</namePart><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Seok Jin</namePart><namePart type="family">Nam</namePart><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yoon La</namePart><namePart type="family">Choi</namePart><affiliation>Pathology and</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Young Hyeh</namePart><namePart type="family">Ko</namePart><affiliation>Pathology and</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Byung Tae</namePart><namePart type="family">Kim</namePart><affiliation>Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jung-Hyun</namePart><namePart type="family">Yang</namePart><affiliation>Surgery,</affiliation><affiliation>Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2006-08</dateIssued><dateCreated encoding="w3cdtf">2006-06-20</dateCreated><copyrightDate encoding="w3cdtf">2006</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Background: The ultrarapid immunohistochemistry (IHC) technique was applied to the intraoperative examination of sentinel lymph nodes (SLNs) because routine SLN frozen section examinations sometimes produce false-negative results. The present study was undertaken to develop a reliable protocol for the ultrarapid IHC of SLNs. Methods: SLNs from 79 breast cancer patients with clinically negative axillary node were examined intraoperatively by frozen hematoxylin–eosin (H&E) stain and by ultrarapid cytokeratin IHC assay. On the basis of the result of serially sectioned permanent study, the sensitivity and accuracy of each intraoperative technique were compared. Results: The total number of dissected SLNs was 178 with a mean of 2.3 (1–5) per patient. The mean turnaround time for ultrarapid IHC was 20 min. The sensitivity rates of frozen H&E staining and ultrarapid IHC were 70.0 and 85.0%, respectively (P = 0.083). Each method had a specificity of 100%. The accuracy rates for frozen H&E staining and rapid IHC were 92.4 and 96.2%, respectively (P = 0.083). Ultrarapid IHC detected one additional patient with sentinel node micrometastasis and two additional patients with isolated tumor cells (ITCs). In those patients, two underwent completion axillary dissection simultaneously and could avoid a second operation. Conclusions: Ultrarapid cytokeratin IHC enhanced the intraoperative detection of sentinel node micrometastasis and ITCs in breast cancer without consuming much time. In patients who need completion axillary dissection after sentinel node biopsy, this technique could be helpful in avoiding a second operation.</abstract><note type="author-notes">For reprints and all correspondence: Jung-Hyun Yang, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Gangnam-gu, Seoul 135-710, Korea. E-mail: jhyang@smc.samsung.co.kr</note><subject lang="en"><genre>KWD</genre><topic>breast cancer</topic><topic>micrometastasis</topic><topic>sentinel lymph node</topic><topic>ultrarapid immunohistochemistry (IHC)</topic></subject><relatedItem type="host"><titleInfo><title>Japanese Journal of Clinical Oncology</title></titleInfo><titleInfo type="abbreviated"><title>JJCO</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0368-2811</identifier><identifier type="eISSN">1465-3621</identifier><identifier type="PublisherID">jjco</identifier><identifier type="PublisherID-hwp">jjco</identifier><identifier type="PublisherID-nlm-ta">Jpn J Clin Oncol</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>36</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>489</start><end>493</end></extent></part></relatedItem><identifier type="istex">A44D271A98F9C007DB6CA407F508CAFFB19D83DC</identifier><identifier type="DOI">10.1093/jjco/hyl045</identifier><identifier type="local">hyl045</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2006 Foundation for Promotion of Cancer Research</accessCondition><recordInfo><recordContentSource>OUP</recordContentSource></recordInfo></mods></metadata><covers><json:item><extension>tiff</extension><original>true</original><mimetype>image/tiff</mimetype><uri>https://api.istex.fr/document/A44D271A98F9C007DB6CA407F508CAFFB19D83DC/covers/tiff</uri></json:item></covers><annexes><json:item><extension>jpeg</extension><original>true</original><mimetype>image/jpeg</mimetype><uri>https://api.istex.fr/document/A44D271A98F9C007DB6CA407F508CAFFB19D83DC/annexes/jpeg</uri></json:item><json:item><extension>gif</extension><original>true</original><mimetype>image/gif</mimetype><uri>https://api.istex.fr/document/A44D271A98F9C007DB6CA407F508CAFFB19D83DC/annexes/gif</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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