A prospective study of false-positive diagnosis of micrometastatic cells in the sentinel lymph nodes in colorectal cancer
| Autor: | David Wiese, Sukamal Saha, B. Yestrepsky, S. Sirop, A. Korant |
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| Rok vydání: | 2009 |
| Předmět: |
medicine.medical_specialty
Pathology Colorectal cancer macromolecular substances Benign tumor Metastasis Breast cancer Medicine Hepatectomy Humans False Positive Reactions Prospective Studies Neoplasm Staging business.industry Sentinel Lymph Node Biopsy Micrometastasis medicine.disease Prognosis Primary tumor body regions Survival Rate Isolated Tumor Cells Treatment Outcome Oncology Lymphatic Metastasis Keratins Surgery Radiology Lymph Lymph Nodes business Colorectal Neoplasms |
| Zdroj: | Annals of surgical oncology. 16(8) |
| ISSN: | 1534-4681 |
| Popis: | Sentinel lymph node mapping (SLNM) with multilevel sections (MLS) and cytokeratin immunohistochemistry (CK-IHC) of sentinel lymph nodes (SLNs) upstages 15–20% of patients (pts). False-positive SLNs occur in breast cancer due to mechanical transport of cells during mapping procedures, or to pre-existing benign cellular inclusions. Our prospective study evaluated whether colorectal mapping procedures alone caused false positives. A total of 314 pts underwent SLNM with blue dye. Ninety of the pts underwent a second mapping in normal bowel away from the primary tumor. The first 1–5 blue nodes near the primary tumor were marked as SLNs; those near the second injection site were marked as nontumor SLNs (nt-SLNs). All SLNs and nt-SLNs were evaluated by MLS and CK-IHC. Of 314 pts, 30 had benign tumor and 284 had invasive cancer. SLNM was successful in 274/284 (96.5%) invasive cancer pts, with 728 SLNs identified. Forty-six of the 274 pts (16.8%) had low-volume metastasis in 57 SLNs: 31 pts (11.3%) had 38 SLNs with micrometastasis (>0.2 mm, ≤2 mm), while 15 pts (5.5%) had 19 SLNs with isolated tumor cells (≤0.2 mm). For 100 pts with second SLNM (70/90 pts successfully mapped with 102 nt-SLNs), or with SLNM of benign pathology (30/30 pts successfully mapped with 88 SLNs), there were no false positives in any of 190 nodes (P |
| Databáze: | OpenAIRE |
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