Intraoperative Examination of Sentinel Lymph Nodes by Ultrarapid Immunohistochemistry in Breast Cancer
Identifieur interne : 007C46 ( Main/Exploration ); précédent : 007C45; suivant : 007C47Intraoperative 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 [Corée du Sud] ; 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
Affiliations:
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(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><affiliations><list><country><li>Corée du Sud</li></country><region><li>Région capitale de Séoul</li></region><settlement><li>Séoul</li></settlement></list><tree><noCountry><name sortKey="Choi, Yoon La" sort="Choi, Yoon La" uniqKey="Choi Y" first="Yoon La" last="Choi">Yoon La Choi</name><name sortKey="Choi, Young Jin" sort="Choi, Young Jin" uniqKey="Choi Y" first="Young Jin" last="Choi">Young Jin Choi</name><name sortKey="Kim, Jung Han" sort="Kim, Jung Han" uniqKey="Kim J" first="Jung Han" last="Kim">Jung Han Kim</name><name sortKey="Ko, Young Hyeh" sort="Ko, Young Hyeh" uniqKey="Ko Y" first="Young Hyeh" last="Ko">Young Hyeh Ko</name><name sortKey="Nam, Seok Jin" sort="Nam, Seok Jin" uniqKey="Nam S" first="Seok Jin" last="Nam">Seok Jin Nam</name><name sortKey="Yang, Jung Hyun" sort="Yang, Jung Hyun" uniqKey="Yang J" first="Jung-Hyun" last="Yang">Jung-Hyun Yang</name><name sortKey="Yoo, Ki Eun" sort="Yoo, Ki Eun" uniqKey="Yoo K" first="Ki Eun" last="Yoo">Ki Eun Yoo</name><name sortKey="Yun, Hae Ran" sort="Yun, Hae Ran" uniqKey="Yun H" first="Hae Ran" last="Yun">Hae Ran Yun</name></noCountry><country name="Corée du Sud"><region name="Région capitale de Séoul"><name sortKey="Kim, Byung Tae" sort="Kim, Byung Tae" uniqKey="Kim B" first="Byung Tae" last="Kim">Byung Tae Kim</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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