Department of Pathology, Johannes Gutenberg University, Medical School, Langenbeckstrasse 1, 55131 Mainz, Germany
Breast Cancer Res Treat. 2012 Apr;132(2):621-4. doi: 10.1007/s10549-011-1923-2. Epub 2011 Dec 22.
Intraoperative examination of sentinel axillary lymph nodes can be done by imprint cytology, frozen section, or, most recently, by PCR-based amplification of a cytokeratin signal. Using this technique, benign epithelial inclusions, representing mammary tissue displaced along the milk line, will likely generate a positive PCR signal and lead to a false-positive diagnosis of metastatic disease. To better appreciate the incidence of ectopic epithelial inclusions in axillary lymph nodes, we have performed an autopsy study, examining on 100 μm step sections 3,904 lymph nodes obtained from 160 axillary dissections in 80 patients. The median number of lymph nodes per axilla was 23 (15, 6, and 1 in levels 1, 2, and 3, respectively). A total of 30,450 hematoxylin-eosin stained slides were examined, as well as 8,825 slides immunostained with pan-cytokeratin antibodies. Despite this meticulous work-up, not a single epithelial inclusion was found in this study, suggesting that the incidence of such inclusions is much lower than the assumed 5% reported in the literature.
前哨腋窝淋巴结的术中检查可通过印片细胞学、冷冻切片，或最近通过细胞角蛋白信号的基于 PCR 的扩增来进行。使用该技术，良性上皮包涵体，代表沿乳腺线移位的乳腺组织，可能会产生阳性的 PCR 信号，并导致转移性疾病的假阳性诊断。为了更好地了解腋窝淋巴结中异位上皮包涵体的发生率，我们进行了一项尸检研究，对 80 名患者的 160 个腋窝解剖中获得的 3904 个淋巴结进行了 100μm 步距切片检查。每个腋窝的中位数淋巴结数为 23 个（1 级、2 级和 3 级分别为 15、6 和 1 个）。总共检查了 30450 张苏木精-伊红染色切片，以及 8825 张用泛细胞角蛋白抗体免疫染色的切片。尽管进行了如此细致的工作，但在这项研究中并未发现单个上皮包涵体，这表明这种包涵体的发生率远低于文献中报道的 5%。
