Baitchev G, Gortchev G, Todorova A
Department of Surgical Oncology, University Centre of Oncology, Pleven, Bulgaria.
Curr Med Res Opin. 2002;18(4):185-7. doi: 10.1185/030079902125000598.
Sentinel lymph nodes (SLNs) predict the axillary status and may allow lymphadenectomy on a selective basis. The aim of this study was to assess the accuracy of intraoperative imprint cytology (IC) analysis of sentinel nodes in patients with early breast cancer.
A total of 128 SLNs from 87 cases that had been identified with Patent blue dye were bisected for hematoxylin and eosin stained touch preparations. Intraoperative evaluation of sentinel node involvement by IC was compared with the final histopathological results of permanent sections. Tumour-negative nodes in standard paraffin sections were further studied using an anticytokeratin antibody (CK-IHC).
Thirty-six of all SLNs contained metastases in paraffin sections, of which 32 were detected by IC procedure (sensitivity 88.8%). Three sentinel nodes were tumour-positive on imprint cytology and tumour-negative on stained paraffin sections. Comparison of the results of the imprints with the final histology (H&E and CK-IHC) showed a sensitivity of 83.3% and a negative predictive value of 92.5%. The specificity and positive predictive value were 100%.
Touch imprint cytology is a simple and quick method of intraoperative screening of SLNs for the presence of metastases in patients with breast cancer. Results may be improved by an appropriate enlargement of the surface sampled and the use of rapid CK-IHC on the touch preparations.
前哨淋巴结（SLN）可预测腋窝状态，并可能允许进行选择性淋巴结清扫术。本研究的目的是评估早期乳腺癌患者前哨淋巴结术中印片细胞学（IC）分析的准确性。
对87例经专利蓝染料标记识别出的128个前哨淋巴结进行对半切开，制作苏木精-伊红染色的触摸涂片。将IC对前哨淋巴结转移情况的术中评估结果与永久切片的最终组织病理学结果进行比较。对标准石蜡切片中肿瘤阴性的淋巴结进一步采用抗细胞角蛋白抗体（CK-IHC）进行研究。
所有前哨淋巴结中，36个在石蜡切片中含有转移灶，其中32个通过IC程序检测到（敏感性88.8%）。3个前哨淋巴结在印片细胞学检查中呈肿瘤阳性，而在染色石蜡切片中呈肿瘤阴性。将印片结果与最终组织学检查（苏木精-伊红染色和CK-IHC）结果进行比较，敏感性为83.3%，阴性预测值为92.5%。特异性和阳性预测值均为100%。
触摸印片细胞学是一种简单快速的术中筛查乳腺癌患者前哨淋巴结有无转移的方法。通过适当扩大取样表面并在触摸涂片上使用快速CK-IHC，结果可能会得到改善。
