Gregurek Steven F, Wu Howard Her-Juing
Department of Pathology, Ball Memorial Hospital, Muncie, IN 47303, USA.
Arch Pathol Lab Med. 2009 Jan;133(1):83-6. doi: 10.5858/133.1.83.
Lymph node status is an important prognostic factor in colorectal cancer staging.
To determine whether the use of GEWF solution (glacial acetic acid, ethanol, distilled water, formaldehyde) increases the yield of lymph nodes (LNs) from colorectal cancer specimens.
A prospective study investigated the usefulness of GEWF in identifying LN from colorectal cancer resection specimens. After standard formalin fixation, approximately half of the specimens were placed in GEWF solution, and the remainder were used as a control. The number of LNs, patient sex, length of specimen, site of the specimen, tumor staging, and the number of positive LNs were analyzed. The numbers of retrieved and metastasis-positive LNs were recorded and compared with specimens from the previous year, in which no GEWF solution was used. Residents were educated on the importance of LN status before the study. Data were analyzed using independent-sample t tests. The residents also completed a subjective survey at the conclusion of the study.
A total of 85 specimens, 45 (53%) with GEWF and 40 (47%) without GEWF, were examined by 11 residents. The mean number of retrieved LNs using GEWF was slightly higher than the control group (19.96 vs 18.30); however, there was no statistical significance (P = .53). The mean number of LNs from the current study (2004- 2005) is significantly higher than that from the previous year (2003-2004) (19.17 vs 11.51, P < .001).
GEWF did not increase the yield of LNs from colorectal cancer specimens. However, application of the guideline for a minimum of 12 LNs significantly increased the LN retrieval.
淋巴结状态是结直肠癌分期中的一个重要预后因素。
确定使用GEWF溶液（冰醋酸、乙醇、蒸馏水、甲醛）是否能提高结直肠癌标本的淋巴结检出率。
一项前瞻性研究调查了GEWF在识别结直肠癌切除标本中淋巴结方面的有效性。在标准福尔马林固定后，大约一半的标本置于GEWF溶液中，其余作为对照。分析淋巴结数量、患者性别、标本长度、标本部位、肿瘤分期以及阳性淋巴结数量。记录并比较回收的和转移阳性的淋巴结数量与上一年未使用GEWF溶液的标本。在研究前对住院医师进行了关于淋巴结状态重要性的培训。使用独立样本t检验分析数据。住院医师在研究结束时还完成了一项主观调查。
11名住院医师共检查了85个标本，其中45个（53%）使用了GEWF，40个（47%）未使用GEWF。使用GEWF回收的淋巴结平均数量略高于对照组（19.96对18.30）；然而，无统计学意义（P = 0.53）。本研究（2004 - 2005年）的淋巴结平均数量显著高于上一年（2003 - 2004年）（19.十七对11.51，P < 0.001）。
GEWF未提高结直肠癌标本的淋巴结检出率。然而，应用至少12个淋巴结的指南显著提高了淋巴结的回收量。
