Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Otolaryngol Head Neck Surg. 2011 Feb;144(2):216-9. doi: 10.1177/0194599810391199. Epub 2011 Jan 4.
To determine the level of sentinel lymph node sectioning necessary to accurately detect nodal micrometastasis.
Cross-sectional.
Tertiary care university medical center.
Fine sections of oral squamous cell carcinoma sentinel lymph nodes previously sectioned at 2-mm intervals in a prospective clinical trial were reexamined. The results yielded from prior hematoxylin and eosin and immunohistochemical staining were compared with results following exhaustive serial sectioning at 150-µm intervals using identical staining methods. These experimental findings were compared with pathologic results of immediate completion selective neck dissection, previously recorded prospectively.
Reexamination of 35 sentinel nodes at 150-µm intervals has not revealed any missed micrometastatic disease at 2-mm intervals used initially. Both comparisons of 150-µm sectioning analysis to the original 2-mm section samples and to the neck dissection pathology reports demonstrate a 100% negative predictive value.
These data suggest that sentinel lymph node sectioning at 2-mm intervals for oral carcinoma using hematoxylin and eosin staining and then immunohistochemical analysis maximizes efficiency, accuracy, and expenditure for the detection of micrometastasis.
确定准确检测淋巴结微转移所需的前哨淋巴结切片水平。
横断面研究。
三级护理大学医疗中心。
对先前在一项前瞻性临床试验中以 2 毫米间隔进行的口腔鳞状细胞癌前哨淋巴结的精细切片进行重新检查。比较了使用相同染色方法以 150-µm 间隔进行的详尽连续切片后获得的苏木精和伊红及免疫组织化学染色的结果与初始使用 2 毫米间隔获得的结果。将这些实验结果与以前前瞻性记录的即刻选择性颈部清扫术的病理结果进行比较。
以 150-µm 间隔对 35 个前哨淋巴结进行重新检查，并未发现最初使用的 2 毫米间隔处有任何遗漏的微转移疾病。150-µm 切片分析与原始 2 毫米切片样本和颈部解剖病理学报告的比较均显示 100%的阴性预测值。
这些数据表明，使用苏木精和伊红染色对口腔癌进行 2 毫米间隔的前哨淋巴结切片，然后进行免疫组织化学分析，可最大限度地提高检测微转移的效率、准确性和支出效率。
