早期乳腺癌中前哨淋巴结术中冰冻切片检查的当前作用。
Current Role of Intraoperative Frozen Section Examination of Sentinel Lymph Node in Early Breast Cancer.
机构信息
Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy
Department of Surgical Oncological and Oral Sciences, University of Palermo, Palermo, Italy.
出版信息
Anticancer Res. 2020 Mar;40(3):1711-1717. doi: 10.21873/anticanres.14124.
BACKGROUND/AIM: The aim of this study was to evaluate the current role of frozen section in identifying patients who could benefit from an immediate axillary lymph node dissection (ALND), following the criteria of the ASOCOG Z0011 and IBCSG 23-10 trials.
PATIENTS AND METHODS
A retrospective review was performed involving 2,079 patients with early breast cancer who underwent conservative surgery or total mastectomy with sentinel lymph node biopsy.
RESULTS
Sensitivity and diagnostic accuracy were 63.8% and 90.3%, respectively. Sensitivity was significantly higher (p<0.001) in finding macrometastases (81.8%) compared to micrometastases (11.9%). Frozen section was useful only in 7.7% of the patients who met the criteria of the IBCSG 23-01 and ACOSOG Z0011 trials.
CONCLUSION
Frozen section continues to be very useful in the intraoperative assessment of the SLN, offering a high sensitivity and diagnostic accuracy. Omission of ALND in 24.4% of patients who met the ACOSOG Z0011 criteria would have resulted in their undertreatment.
背景/目的：本研究旨在评估根据 ASOCOG Z0011 和 IBCSG 23-10 试验标准，冷冻切片在确定哪些患者可以从即刻腋窝淋巴结清扫术（ALND）中获益方面的当前作用。
患者和方法
回顾性分析了 2079 例接受保乳手术或前哨淋巴结活检的早期乳腺癌患者。
结果
敏感性和诊断准确性分别为 63.8%和 90.3%。与微转移（11.9%）相比，发现宏转移（81.8%）的敏感性显著更高（p<0.001）。仅 7.7%符合 IBCSG 23-01 和 ACOSOG Z0011 试验标准的患者可从冷冻切片中获益。
结论
冷冻切片在 SLN 的术中评估中仍然非常有用，具有较高的敏感性和诊断准确性。如果对符合 ACOSOG Z0011 标准的 24.4%患者省略 ALND，可能会导致治疗不足。
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