前哨淋巴结印片细胞学检查在评估乳腺癌腋窝淋巴结状态中的应用

Imprint cytology of the sentinel lymph node in the assessment of axillary node status in breast carcinoma.

作者信息

Ravichandran D, Kocjan G, Falzon M, Ball R Y, Ralphs D N L

机构信息

Breast Unit, Luton and Dunstable Hospital, Luton LU4 0DZ, UK.

出版信息

Eur J Surg Oncol. 2004 Apr;30(3):238-42. doi: 10.1016/j.ejso.2003.11.005.

DOI:10.1016/j.ejso.2003.11.005

PMID:15028302

Abstract

BACKGROUND

Intra-operative assessment of the sentinel lymph node (SLN) status may allow the surgeon to complete the breast cancer surgery in most patients in one sitting. We have studied the role of imprint cytology in the assessment of SLN status.

PATIENTS AND METHODS

Imprint cytology of the SLN in 132 patients with invasive breast carcinoma was correlated with the histopathological assessment of the SLN and overall axillary nodal status. In 26 patients, the cytology was reported intra-operatively.

RESULTS

Imprint cytology reflected the status of the parent node well (sensitivity 86%, specificity 97%, positive predictive value (PPV) 92%, negative predictive value (NPV) 93%). Its ability to reflect the axillary status was also good (sensitivity 70%, specificity 97%, PPV 95% and NPV 83%) but somewhat diminished by the relatively high number of false-negative SLN in the study. Intra-operative assessment (sensitivity 86%, specificity 100%, PPV 100% and NPV 95%) did not reduce the accuracy of imprint cytology in predicting the SLN status and took a mean of 24.5 min.

CONCLUSIONS

Imprint cytology is an accurate and relatively simple method for the assessment of the SLN and can be a useful intra-operative tool.

摘要

背景

术中评估前哨淋巴结（SLN）状态可使外科医生在大多数患者中一次性完成乳腺癌手术。我们研究了印片细胞学在评估SLN状态中的作用。

患者与方法

对132例浸润性乳腺癌患者的SLN进行印片细胞学检查，并与SLN的组织病理学评估及腋窝淋巴结总体状态相关联。26例患者的细胞学检查在术中报告。

结果

印片细胞学很好地反映了母节点的状态（敏感性86%，特异性97%，阳性预测值（PPV）92%，阴性预测值（NPV）93%）。其反映腋窝状态的能力也很好（敏感性70%，特异性97%，PPV 95%，NPV 83%），但由于研究中假阴性SLN数量相对较多，其能力有所下降。术中评估（敏感性86%，特异性100%，PPV 100%，NPV 95%）并未降低印片细胞学预测SLN状态的准确性，平均用时24.5分钟。