Sfeclan M C, Mirea C S, Ciorbagiu M C, Vîlcea A M, Obleagă C V, Pădureanu V, Cârţu D, Țenea-Cojan T Ș, Moraru E, Vîlcea I D
The 2nd Department of Surgery, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania.
Department of Dermatology-Venerology, Faculty of Medicine, University of Medicine and Pharmacy of Craiova, Romania.
Curr Health Sci J. 2017 Jan-Mar;43(1):47-53. doi: 10.12865/CHSJ.43.01.07. Epub 2017 Sep 27.
Identification of sentinel lymph node (SLN) in colon cancer is very important in order to increase the accuracy of lymph node staging. The number of examined lymph nodes represents a significant predictor of survival. This study aims to show the importance of SLN histological and immunohistochemical examination in adjuvant oncological treatment. The study includes 23 patients with colon cancer (44% women and 56% men) who came in our clinic for surgical intervention. In all cases, the SLN was identified and prepared for histological examination. In 13 of the cases, micrometastases were found onhaematoxylin-eosin (HE) staining, there were 5 cases with positive immunohistochemistry using antibodies anti-p53, anti-VEGF-C, anti-CD34, and 5 cases with SLN negative both for HE and immunohistochemistry. Altogether we had a detection rate of 92%, an accuracy of 78,2%, a sensitivity of 90%, a false negative rate of 10% and a negative predictive value of 71,4%, good values according to the literature. Four (17,3%) patients had micrometastases exclusively in the sentinel lymph node, after performing additional histological examination, using multilevel section and immunohistochemistry. After assessing the SNL on our patients, we concluded that it is a reproducible practice for lymph node analysis.
识别结肠癌前哨淋巴结(SLN)对于提高淋巴结分期的准确性非常重要。检查的淋巴结数量是生存的重要预测指标。本研究旨在表明SLN组织学和免疫组化检查在辅助肿瘤治疗中的重要性。该研究纳入了23例结肠癌患者(44%为女性,56%为男性),他们前来我们诊所接受手术干预。在所有病例中,均识别出SLN并准备进行组织学检查。其中13例在苏木精-伊红(HE)染色中发现微转移,5例使用抗p53、抗VEGF-C、抗CD34抗体免疫组化呈阳性,5例SLN在HE染色和免疫组化中均为阴性。总体而言,我们的检测率为92%,准确率为78.2%,灵敏度为90%,假阴性率为10%,阴性预测值为71.4%,根据文献,这些都是不错的值。在进行额外的组织学检查、使用多层切片和免疫组化后,4例(17.3%)患者仅在前哨淋巴结中有微转移。在对我们的患者进行前哨淋巴结评估后,我们得出结论,它是一种可重复的淋巴结分析方法。