[乳腺癌前哨淋巴结术中触摸印片细胞学评估]

[Evaluation of intraoperative touch imprint cytology of sentinel lymph node for breast cancer].

作者信息

Huang Xiao-yan, Wu Jiong, Xu Wei-ping, Wang Long-fu, Shi Da-ren, Zhou Min, Zhang Jia-xin, Han Qi-xia, Shen Kun-wei, Shen Zken-Zhou, Shao Zhi-min

机构信息

Department of Breast Surgery, Cancer Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2007 Aug;29(8):596-9.

PMID:18210879

Abstract

OBJECTIVE

To evaluate the intraoperative touch imprint cytology as an diagnostic method of sentinel lymph node for breast cancer patient.

METHODS

Sentinel lymph node biopsy was performed in 105 selected early breast cancer patients, and sentinel lymph node was identified in 101 (96.19%) of these patients. Axillary lymph node dissection was also performed in almost all the patients. All the sentinel lymph nodes were cut into 2-3 mm pieces along the long axis. Touch imprint was made of each piece of the sentinel lymph node, then air-dried, and finally stained with H&E. Intraoperative touch imprint cytology results were compared with the final paraffin H&E pathology. All sentinel nodes were cut into 4 microm sections every 100-microm interval, and the series sections were stained with H&E.

RESULTS

202 sentinel lymph nodes were identified in 101 breast cancer patients. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of intraoperative imprint cytology for 202 sentinel nodes was 92.1%, 98.8%, 97.5%, 94.6% and 98.2%, respectively; which was 89.3%, 98.6%, 96.0%, 96.2% and 96.0%, respectively in the 101 patients with identified sentinel node. Compared with the series sections, the sensitivity, specificity, accuracy, positive predictive value, negative predictive value of intraoperative imprint cytology for sentinel nodes was 83.3%, 98.8%, 95.5%, 94.6% and 95.8%, respectively; and it was 81.3%, 100.0%, 94.1%, 100.0% and 92.0%, respectively in 101 patients with identified sentinel node.

CONCLUSION

Touch imprint cytology is a simple, effective and rapid method for intraoperative pathological evaluation of sentinel lymph node for breast cancer patient, which has a high concordance with the paraffin results, and can provide accurate and rapid diagnosis information for the surgeon during operation.

摘要

目的

评估术中触摸印片细胞学检查作为乳腺癌患者前哨淋巴结诊断方法的价值。

方法

对105例择期早期乳腺癌患者行前哨淋巴结活检，其中101例（96.19%）成功识别出前哨淋巴结。几乎所有患者均行腋窝淋巴结清扫术。将所有前哨淋巴结沿长轴切成2 - 3毫米的薄片。对每片前哨淋巴结制作触摸印片，然后风干，最后进行苏木精-伊红（H&E）染色。将术中触摸印片细胞学检查结果与最终石蜡H&E病理结果进行比较。所有前哨淋巴结每隔100微米切成4微米厚的切片，系列切片进行H&E染色。

结果

101例乳腺癌患者共识别出202枚前哨淋巴结。术中印片细胞学检查对202枚前哨淋巴结的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为92.1%、98.8%、97.5%、94.6%和98.2%；在101例识别出前哨淋巴结的患者中分别为89.3%、98.6%、96.0%、96.2%和96.0%。与系列切片相比，术中印片细胞学检查对前哨淋巴结的敏感性、特异性、准确性、阳性预测值、阴性预测值分别为83.3%、98.8%、95.5%、94.6%和95.8%；在101例识别出前哨淋巴结的患者中分别为81.3%、100.0%、94.1%、100.0%和92.0%。