Department of Genetics and Laboratory Medicine, Geneva University Hospitals, 1211 Geneva 14, Switzerland.
Anticancer Res. 2009 Nov;29(11):4711-6.
Sentinel lymph node (SLN) biopsy plays a major role in the surgical management of primary breast cancer. The aim of this study was to assess the diagnostic accuracy of the assessment of axillary frozen sections of SLNs for micrometastasis diagnosis.
This study focused on 278 SLNs from 149 patients. Each lymph node was fully analyzed by frozen section. After fixation, serial sections were cut and stained by hematoxylin and eosin (HE) and for pan-cytokeratins by immunohistochemistry (IHC).
Tumor cells were detected in 63 SLNs, 41 on frozen sections and 22 on controls. Of these 63 positive SLNs, 42 contained metastases, 10 contained micrometastases and 11 contained isolated tumor cells. The specificity and positive predictive value of SLN frozen sections for micrometastasis was 100%. The sensitivity was 83.3% for metastasis, 40% for micrometastasis; the false-negative rate was 16.7% for metastasis and 60% for micrometastasis.
Analysis of frozen section of SLNs is an accurate method for metastasis detection, allowing concurrent axillary dissection when positive. The protocol for SLN analyses described herein shows good sensitivity for micrometastasis detection.
前哨淋巴结（SLN）活检在原发性乳腺癌的外科治疗中起着重要作用。本研究旨在评估 SLN 腋窝冷冻切片微转移诊断评估的诊断准确性。
本研究集中于 149 例患者的 278 个 SLN。每个淋巴结均通过冷冻切片进行全面分析。固定后，通过苏木精和伊红（HE）和细胞角蛋白免疫组化（IHC）对连续切片进行染色。
在 63 个 SLN 中检测到肿瘤细胞，41 个在冷冻切片中，22 个在对照组中。在这 63 个阳性 SLN 中，42 个包含转移，10 个包含微转移，11 个包含孤立的肿瘤细胞。SLN 冷冻切片的特异性和阳性预测值为 100%。转移的敏感性为 83.3%，微转移为 40%；假阴性率为转移的 16.7%和微转移的 60%。
SLN 冷冻切片分析是一种准确的转移检测方法，当结果阳性时可同时进行腋窝清扫。本文描述的 SLN 分析方案对微转移检测具有良好的敏感性。
