Zeng Jian, Xie Huazhi, Lu Yunfei, Feng Zhenbo, Li Fu
Department of Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China.
Breast Care (Basel). 2012 Jun;7(3):216-219. doi: 10.1159/000339686. Epub 2012 Jun 22.
The aim of this study was to assess the efficiency of step-serial sectioning (SSS) combined with hematoxylin and eosin (H&E) and immunohistochemical (IHC) staining in detecting micrometastasis of internal mammary lymph nodes (IMLNs). PATIENTS AND METHODS: 135 IMLNs from 88 breast cancer patients were re-examined by SSS, combined with either H&E or IHC staining of the biomarkers cytokeratin-19 and epithelial membrane antigen. RESULTS: Of the 135 IMLNs, 6 nodes from 5 cases displayed 1 or more micrometastases. Histological grade and lymphovascular invasion status were significantly correlated with micrometastasis in the IMLNs (p = 0.018 and 0.001, respectively). Of the 6 nodes positive for micrometastasis, 1 node was detected by both H&E and IHC staining. The remaining 5 nodes from 4 cases showed evident tumor cells only by IHC staining. Finally 8 of the 83 patients (9.64%) without IMLN metastasis showed distant metastasis, while 2 of the 5 patients (40%) with IMLN metastasis showed distant metastasis within 28 months of operation. CONCLUSION: SSS combined with H&E and IHC staining is more efficient in detecting micrometastasis than classic routine single-slice H&E only.
本研究旨在评估连续阶梯切片（SSS）联合苏木精-伊红（H&E）染色及免疫组化（IHC）染色检测内乳淋巴结（IMLNs）微转移的效率。
对88例乳腺癌患者的135枚IMLNs采用SSS联合生物标志物细胞角蛋白-19和上皮膜抗原的H&E或IHC染色进行重新检查。
在135枚IMLNs中，5例患者的6枚淋巴结显示1处或多处微转移。组织学分级和淋巴管浸润状态与IMLNs中的微转移显著相关（分别为p = 0.018和0.001）。在6枚微转移阳性的淋巴结中，1枚通过H&E和IHC染色均被检测到。其余来自4例患者的5枚淋巴结仅通过IHC染色显示有明显的肿瘤细胞。最后，83例无IMLNs转移的患者中有8例（9.64%）出现远处转移，而5例有IMLNs转移的患者中有2例（40%）在术后28个月内出现远处转移。
与仅采用经典常规单切片H&E相比，SSS联合H&E和IHC染色在检测微转移方面更有效。
