未能切除真正的前哨淋巴结会导致前哨淋巴结活检技术失败：来自黑色素瘤患者假阴性前哨淋巴结中锑浓度的证据。

Failure to remove true sentinel nodes can cause failure of the sentinel node biopsy technique: evidence from antimony concentrations in false-negative sentinel nodes from melanoma patients.

作者信息

Scolyer Richard A, Thompson John F, Li Ling-Xi L, Beavis Alison, Dawson Michael, Doble Phillip, Ka Vivian S K, McKinnon J Gregory, Soper Robyne, Uren Roger F, Shaw Helen M, Stretch Jonathan R, McCarthy Stanley W

机构信息

Sydney Melanoma Unit and Melanoma and Skin Cancer Research Institute, Royal Prince Alfred Hospital, Camperdown, Australia.

出版信息

Ann Surg Oncol. 2004 Mar;11(3 Suppl):174S-8S. doi: 10.1007/BF02523624.

DOI:10.1007/BF02523624

PMID:15023747

Abstract

We have recently found that antimony (originating from the technetium 99m antimony trisulfide colloid, used for preoperative lymphoscintigraphy) can be measured in tissue sections from archival paraffin blocks of sentinel nodes (SNs) by means of inductively coupled plasma mass spectrometry (ICP-MS) to confirm that removed nodes are true SNs. We performed a retrospective analysis of antimony concentrations in all our false-negative (FN) SNs to determine whether errors in lymphadenectomy (i.e., failure to remove true SNs) may be a cause of FN SN biopsies (SNBs). Among 27 patients with an FN SNB, metastases were found on histopathologic review of the original slides or additional sections in 7 of 23 patients for which they were available; however, antimony concentrations were low in 5 of 20 presumptive SNs. Our results suggest that an FN SNB can occur because of failure to remove the true SN as well as histopathologic misdiagnosis.

摘要

我们最近发现，通过电感耦合等离子体质谱法（ICP-MS）可以在前哨淋巴结（SN）存档石蜡块的组织切片中检测到锑（源自用于术前淋巴闪烁显像的锝99m硫化锑胶体），以确认切除的淋巴结为真正的SN。我们对所有假阴性（FN）SN中的锑浓度进行了回顾性分析，以确定淋巴结清扫术中的错误（即未能切除真正的SN）是否可能是FN SN活检（SNB）的原因。在27例FN SNB患者中，对23例有原始切片或额外切片可供进行组织病理学复查的患者进行检查，发现其中7例有转移；然而，在20个推定SN中的5个中锑浓度较低。我们的结果表明，FN SNB可能是由于未能切除真正的SN以及组织病理学误诊所致。