Lewis V, Rice P
Department of Pathology and Surgery, Southampton University General Hospital, U.K.
J Pathol. 1988 Jul;155(3):221-4. doi: 10.1002/path.1711550307.
In this prospective study, axillary clearance specimens from consecutive routine mastectomies and wide excisions for carcinoma were divided into three segments by sutures in the theatre: apical (furthest from the tumour), mid and basal (nearest to the tumour) segments. Each specimen was then randomized to either formalin or Carnoy's fixation. Following fixation, lymph nodes were dissected from each of the three segments, sectioned once through the hilum, and examined microscopically. There was a significant (P less than 0.05) difference in the total number and number of reactive lymph nodes harvested from Carnoy's compared with formalin-fixed material. The number of nodes containing metastatic carcinoma was not significantly different (P = 0.64). In several cases, involved apical segment lymph nodes were found with no involvement of the proximal groups; this observation may have serious implications for the procedure of proximal lymph node sampling in the surgical management of breast cancer. It is suggested that clearing of axillary contents with Carnoy's fixative does not provide any additional information of clinical significance, although it may allow the pathologist to identify lymph nodes rapidly.
在这项前瞻性研究中，连续接受常规乳房切除术和乳腺癌广泛切除术的腋窝清扫标本在手术室中通过缝线分为三个部分：尖部（离肿瘤最远）、中部和基部（离肿瘤最近）。然后将每个标本随机分为福尔马林固定或卡诺氏固定。固定后，从三个部分中分别取出淋巴结，沿淋巴结门部切一刀，然后进行显微镜检查。与福尔马林固定的材料相比，卡诺氏固定材料所获取的反应性淋巴结总数和数量存在显著差异（P<0.05）。含有转移性癌的淋巴结数量无显著差异（P = 0.64）。在几例病例中，发现尖部淋巴结受累而近端组未受累；这一观察结果可能对乳腺癌手术治疗中近端淋巴结取样程序具有严重影响。建议使用卡诺氏固定剂清除腋窝内容物并不能提供任何具有临床意义的额外信息，尽管它可能使病理学家能够快速识别淋巴结。
