Durkin K, Haagensen C D
Ann Surg. 1980 Apr;191(4):419-29. doi: 10.1097/00000658-198004000-00006.
The importance of the meticulous study by pathologists of the lymph nodes in surgical specimens is emphasized. Most pathologists identify only a small proportion of the lymph nodes in these specimens and valuable prognostic information is lost. Data illustrating the evolution in the Columbia Laboratory of surgical pathology of methods used to study surgical lymph node specimens over a 44-year period (1935--1979) are reviewed. An improved method of clearing the specimens of axillary dissections in radical mastectomy finds more lymph nodes and more metastases, and greatly shortens the time required for clearing. The importance of identifying metastases in the interpectoral nodes is emphasized. In a special study with our new clearing technique metastases were found in the interpectoral nodes in 19% of the radical mastectomy specimens. These nodes are not removed in the modified operation, which does not include resection of the pectoral muscles. The opportunity to cure a substantial proportion of patients is thus lost.
强调了病理学家对手术标本中的淋巴结进行细致研究的重要性。大多数病理学家只能识别这些标本中一小部分淋巴结，从而丢失了有价值的预后信息。回顾了哥伦比亚外科病理学实验室在44年期间（1935 - 1979年）用于研究手术淋巴结标本的方法演变的数据。一种改进的用于清除根治性乳房切除术中腋窝清扫标本的方法能发现更多的淋巴结和转移灶，并大大缩短了清除所需的时间。强调了识别胸肌间淋巴结转移的重要性。在一项使用我们新的清除技术的专项研究中，在19%的根治性乳房切除标本的胸肌间淋巴结中发现了转移灶。在改良手术中这些淋巴结未被切除，改良手术不包括切除胸肌。因此失去了治愈相当一部分患者的机会。
