Alkuwari Einas, Auger Manon
Department of Pathology, McGill University Health Center, McGill University, Montreal, Quebec, Canada.
Cancer. 2008 Apr 25;114(2):89-93. doi: 10.1002/cncr.23344.
Fine-needle aspiration (FNA) cytology of axillary lymph nodes is a simple, minimally invasive technique that can be used to improve preoperative determination of the status of the axillary lymph nodes in patients with breast cancer, thereby serving as a tool with which to triage patients for sentinel versus full lymph node dissection procedures. The aim of the current study was to determine the sensitivity and specificity of FNA cytology to detect metastatic breast carcinoma in axillary lymph nodes.
A total of 115 FNAs of axillary lymph nodes of breast cancer patients with histologic follow-up (subsequent sentinel or full lymph node dissection) were included in the current study. The specificity and sensitivity, as well as the positive and negative predictive values, were calculated.
The positive and negative predictive values of FNA cytology of axillary lymph nodes for metastatic breast carcinoma were 1.00 and 0.60, respectively. The overall sensitivity of axillary lymph node FNA in all the cases studied was 65% and the specificity was 100%. The sensitivity of FNA was lower in the sentinel lymph node group than in the full lymph node dissection group (16% vs 88%, respectively), which was believed to be attributable to the small size of the metastatic foci in the sentinel lymph node group (median, 0.25 cm). All false-negative FNAs, with the exception of 1 case, were believed to be the result of sampling error. There was no 'true' false-positive FNA case in the current study.
FNA of axillary lymph nodes is a sensitive and very specific method with which to detect metastasis in breast cancer patients. Because of its excellent positive predictive value, full axillary lymph node dissection can be planned safely instead of a sentinel lymph node dissection when a preoperative positive FNA result is rendered. .
腋窝淋巴结细针穿刺（FNA）细胞学检查是一种简单的微创技术，可用于改善乳腺癌患者腋窝淋巴结状态的术前判定，从而作为一种工具对患者进行分流，以决定是进行前哨淋巴结活检还是全腋窝淋巴结清扫术。本研究的目的是确定FNA细胞学检查检测腋窝淋巴结转移性乳腺癌的敏感性和特异性。
本研究纳入了115例接受过组织学随访（随后进行前哨或全腋窝淋巴结清扫）的乳腺癌患者的腋窝淋巴结FNA样本。计算了特异性、敏感性以及阳性和阴性预测值。
腋窝淋巴结FNA细胞学检查对转移性乳腺癌的阳性和阴性预测值分别为1.00和0.60。在所有研究病例中，腋窝淋巴结FNA的总体敏感性为65%，特异性为100%。前哨淋巴结组中FNA的敏感性低于全腋窝淋巴结清扫组（分别为16%和88%），这被认为是由于前哨淋巴结组中转移灶较小（中位数为0.25 cm）。除1例病例外，所有假阴性FNA均被认为是抽样误差所致。本研究中没有“真正的”假阳性FNA病例。
腋窝淋巴结FNA是检测乳腺癌患者转移的一种敏感且非常特异的方法。由于其出色的阳性预测值，当术前FNA结果为阳性时，可以安全地计划进行全腋窝淋巴结清扫，而不是前哨淋巴结活检。
