Diaz Nils M, Cox Charles E, Ebert Mark, Clark John D, Vrcel Vesna, Stowell Nicholas, Sharma Anu, Jakub James W, Cantor Alan, Centeno Barbara A, Dupont Elisabeth, Muro-Cacho Carlos, Nicosia Santo
Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL 33612, USA.
Am J Surg Pathol. 2004 Dec;28(12):1641-5. doi: 10.1097/00000478-200412000-00014.
The evaluation of sentinel lymph nodes (SLNs) for the presence of malignant epithelial cells is essential to the staging of breast cancer patients. Recently, increased attention has focused on the possibility that epithelial cells may reach SLNs by benign mechanical means, rather than by metastasis. The purpose of this study was to test the hypothesis that pre-SLN biopsy breast massage, which we currently use to facilitate the localization of SLNs, might represent a mode of benign mechanical transport. We studied 56 patients with invasive and/or in situ ductal carcinoma and axillary SLNs with only epithelial cells and/or cell clusters (< or =0.2 mm in diameter and not associated with features of established metastases) detected predominantly in subcapsular sinuses of SLNs on hematoxylin and eosin- and/or anti-cytokeratin-stained sections. No patient had an SLN involved by either micro- or macro-metastatic carcinoma. Epithelial cells and cell clusters, < or =0.2 mm in size and without features of established metastases, occurred more frequently in the SLNs of patients who underwent pre-SLN biopsy breast massage (P < 0.001, chi2 test). The latter finding supports the hypothesis that pre-SLN biopsy breast massage is a mode of benign mechanical transport of epithelial cells to SLNs.
评估前哨淋巴结（SLN）中是否存在恶性上皮细胞对于乳腺癌患者的分期至关重要。最近，人们越来越关注上皮细胞可能通过良性机械方式而非转移到达前哨淋巴结的可能性。本研究的目的是检验以下假设：我们目前用于促进前哨淋巴结定位的前哨淋巴结活检前乳房按摩可能是一种良性机械运输方式。我们研究了56例浸润性和/或原位导管癌患者以及腋窝前哨淋巴结，在苏木精和伊红染色及/或抗细胞角蛋白染色切片上，在前哨淋巴结的被膜下窦中主要检测到仅上皮细胞和/或细胞团（直径≤0.2mm且与已确立转移的特征无关）。没有患者的前哨淋巴结有微转移或宏转移癌累及。在接受前哨淋巴结活检前乳房按摩的患者的前哨淋巴结中，大小≤0.2mm且无已确立转移特征的上皮细胞和细胞团更频繁出现（P<0.001，卡方检验）。后一发现支持了前哨淋巴结活检前乳房按摩是上皮细胞向前哨淋巴结良性机械运输方式的假设。
