Zhang Tao, Zhang Bao-Ning, Zhang Hong-Tu, Sun Yun-Tian
Department of Surgical Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Medical College, Beijing 100021, China.
Zhonghua Zhong Liu Za Zhi. 2007 Feb;29(2):116-8.
To investigate an optimal examination method to detect micrometastases in sentinel lymph nodes (SLNs) of breast cancer.
Firstly, the SLNs of breast cancer were found by 99mTc-DX isotope method. Secondly, all the SLNs which were negative by routine HE examination were serially sectioned at a 100 microm interval and stained by both HE and immunohistochemistry for detecting micrometastases. All tumor tissue paraffin blocks were also sectioned and stained with HE and immunohistochemistry as control.
Totally, 121 SLNs and 44 tumors of 59 patients were examined. Micrometastasis was found to be positive in 17 SLNs (14.0%) of 14 patients (23.7%). When examined number of sections was increased from one to three, more positive micrometastatic SLNs were detected by HE staining only (3, 7, 10 for 1, 2, 3 sections, respectively). When HE staining was combined with immunohistochemical staining for AE1/3 or CK19 or muc1, much more positive micrometastatic SLNs were found (14, 12, 16 for 1, 2, 3 sections, respectively). The more sections were examined, the more micrometastases in SLNs were found. Furthermore, micrometastasis was also found to be positively correlated with the tumor size and the expression of c-erbB2, MMP-2, VEGF. The larger the tumor size was or the stronger expression of the above mentioned biomarkers, the more micrometastases in SLNs could be found.
Serially sections at a 100 microm interval and staining with both HE and immunohistochemical technique using muc1 antibody may be the best way to detect micrometastases in sentinel lymph nodes in breast cancer patients.
探讨检测乳腺癌前哨淋巴结（SLN）微转移的最佳检查方法。
首先，采用99mTc-DX同位素法查找乳腺癌的前哨淋巴结。其次，将所有常规HE检查为阴性的前哨淋巴结以100微米的间隔连续切片，并用HE和免疫组织化学染色以检测微转移。所有肿瘤组织石蜡块也进行切片，并进行HE和免疫组织化学染色作为对照。
共检查了59例患者的121个前哨淋巴结和44个肿瘤。14例患者（23.7%）的17个前哨淋巴结（14.0%）微转移呈阳性。当检查的切片数量从1张增加到3张时，仅通过HE染色检测到的微转移阳性前哨淋巴结更多（1张、2张、3张切片分别为3个、7个、10个）。当HE染色与AE1/3或CK19或muc1的免疫组织化学染色相结合时，发现的微转移阳性前哨淋巴结更多（1张、2张、3张切片分别为14个、12个、16个）。检查的切片越多，在前哨淋巴结中发现的微转移就越多。此外，还发现微转移与肿瘤大小以及c-erbB2、MMP-2、VEGF的表达呈正相关。肿瘤越大或上述生物标志物的表达越强，在前哨淋巴结中发现的微转移就越多。
以100微米的间隔连续切片并用muc1抗体进行HE和免疫组织化学技术染色可能是检测乳腺癌患者前哨淋巴结微转移的最佳方法。
