Department of Surgical, Oncological & Gastroenterological Sciences (DiSCOG), University of Padua, School of Medicine, Padova, Italy.
Anticancer Res. 2012 Aug;32(8):3523-6.
Sentinel lymph node biopsy (SLNB) is currently the suggested axillary staging procedure in patients with early-stage breast cancer (BC) and usually requires intraoperative frozen-section (FS) examination of the removed nodes. However, other techniques, such as touch imprint cytology (IC), real-time reverse transcriptase-polymerase chain reaction and rapid cytokeratin immunostaining on FS may be used. The aim of this preliminary study was to assess the usefulness of intraoperative IC and FS section analysis together in improving the accuracy of sentinel lymph node evaluation in patients with early BC, who underwent SLNB. A series of 126 consecutive women (median age 52, range 34-71 years) with T1 (≤20 mm) BC, were prospectively enrolled in the study. A total of 221 axillary nodes were processed for both IC and FS intraoperative evaluation. Final pathology revealed 74 out of 221 (33.5%) nodes with metastasis, out of which 51 (68.9%) had macrometastases. Overall, 31 out of 126 (24.6%) patients were staged as having pN1mi or pN1a. The sensitivity, specificity, and accuracy in detecting metastases were 75.7%, 100% and 91.9% for FS, 70.3%, 98.6% and 89.1% for IC, and 89.2%, 100% and 96.0% for IC+FS together, respectively. The sensitivity of FS and IC did not differ significantly (p=0.46), while the combination of FS+IC showed a higher sensitivity (p=0.03), and similar accuracy. Our preliminary data confirm that IC is a simple and rapid technique with good sensitivity, suggesting that the combination of FS and IC may be useful in all patients requiring intraoperative SLNB evaluation.
前哨淋巴结活检（SLNB）目前是早期乳腺癌（BC）患者建议的腋窝分期程序，通常需要对切除的淋巴结进行术中冷冻切片（FS）检查。然而，也可以使用其他技术，如触诊印片细胞学（IC）、实时逆转录-聚合酶链反应和 FS 上的快速细胞角蛋白免疫染色。本初步研究的目的是评估术中 IC 和 FS 切片分析联合应用于提高接受 SLNB 的早期 BC 患者前哨淋巴结评估的准确性。一项前瞻性研究共纳入了 126 例连续的 T1（≤20mm）BC 女性患者（中位年龄 52 岁，范围 34-71 岁），共处理了 221 个腋窝淋巴结用于 IC 和 FS 术中评估。最终病理显示 221 个淋巴结中有 74 个（33.5%）有转移，其中 51 个（68.9%）有大转移灶。总体而言，126 例患者中有 31 例（24.6%）分期为 pN1mi 或 pN1a。FS 检测转移的敏感性、特异性和准确性分别为 75.7%、100%和 91.9%，IC 分别为 70.3%、98.6%和 89.1%，FS+IC 联合检测分别为 89.2%、100%和 96.0%。FS 和 IC 的敏感性无显著差异（p=0.46），而 FS+IC 的联合检测则显示出更高的敏感性（p=0.03）和相似的准确性。我们的初步数据证实 IC 是一种简单、快速的技术，具有良好的敏感性，提示 FS 和 IC 的联合应用可能对所有需要术中 SLNB 评估的患者都有用。
