Veys Isabelle, Durbecq Virginie, Majjaj Samira, Schobbens Jean Christophe, Noterman Danielle, Sirtaine Nicolas, Martinez Maria Dolores Martin, Hertens Dina, Feoli Francesco, Bourgeois Pierre, Nogaret Jean-Marie, Larsimont Denis
Department of Surgery, Jules Bordet Institute, Université Libre de Bruxelles, Belgium.
Am J Surg. 2009 Aug;198(2):203-9. doi: 10.1016/j.amjsurg.2008.09.012. Epub 2009 Feb 27.
The accuracy of a molecular reverse transcriptase-polymerase chain reaction (RT-PCR)-based assay for metastases detection in axillary sentinel lymph nodes (SLNs) has recently been validated in our institution and adopted as an intraoperative test for breast cancer patient management.
Molecular assay performance was compared to standard postoperative histology in 253 consecutive patients with clinically node-negative T1 early breast cancer (<2 cm).
The molecular assay correctly identified 26/27 macrometastases and 11/15 micrometastases. Overall concordance with histopathology was 93%, with 87% sensitivity, 94% specificity, and 75% positive and 97% negative predictive values. The molecular assay was positive in 13/14 patients with SLNs and nonsentinel lymph node (axillary lymph node [ALN])-positive histology. Notably, 2/12 patients with assay-positive/histology-negative SLNs exhibited ALN positivity.
This molecular assay can raise the standard of care for patient management as its accuracy is similar to that of standard postoperative histology with the advantage of being standardized, objective, and fast enough for intraoperative use.
基于分子逆转录聚合酶链反应（RT-PCR）的检测腋窝前哨淋巴结（SLN）转移灶的检测方法的准确性最近在我们机构得到验证，并被用作乳腺癌患者管理的术中检测方法。
将253例临床淋巴结阴性的T1期早期乳腺癌（<2 cm）患者的分子检测结果与标准术后组织学结果进行比较。
分子检测正确识别出26/27例大转移灶和11/15例微转移灶。与组织病理学的总体一致性为93%，敏感性为87%，特异性为94%，阳性预测值为75%，阴性预测值为97%。在14例SLN和非前哨淋巴结（腋窝淋巴结[ALN]）组织学阳性的患者中，分子检测有13例呈阳性。值得注意的是，2/12例检测阳性/组织学阴性的SLN患者表现出ALN阳性。
这种分子检测方法可以提高患者管理的护理标准，因为其准确性与标准术后组织学相似，且具有标准化、客观且速度足够快可用于术中的优点。
