Rapid intraoperative immunohistochemical evaluation of sentinel lymph nodes for metastatic breast carcinoma
| Autor: | Sandra M. Waldrop, Elizabeth I. Johnston, Diane Lawson, Robyn A. Beach, Cynthia Cohen |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Adult
medicine.medical_specialty Histology Time Factors Breast Neoplasms Sensitivity and Specificity Pathology and Forensic Medicine Metastatic carcinoma Intraoperative Period Breast cancer Biopsy Medicine Humans Lymph node Aged Aged 80 and over Frozen section procedure medicine.diagnostic_test business.industry Sentinel Lymph Node Biopsy Middle Aged medicine.disease Immunohistochemistry Medical Laboratory Technology medicine.anatomical_structure Lymphatic Metastasis Female Lymph Radiology business |
| Zdroj: | Applied immunohistochemistrymolecular morphology : AIMM. 14(1) |
| ISSN: | 1541-2016 |
| Popis: | Sentinel lymph node (SLN) biopsy is an integral part of the surgical management of patients with breast cancer. Rapid immunohistochemistry (RIHC) has the potential to increase detection of metastatic carcinoma at the time of frozen section consultation. The authors assessed the accuracy and turnaround time of a newly developed RIHC method for pancytokeratin (RIHC-CK).Sixty-six SLNs from 32 patients with breast carcinoma were examined for metastasis using the Zymed Sentinel Lymph Node Rapid IHC Kit. Intraoperative frozen sections (6 mum) of the SLNs were incubated with Zymed anti-pan-cytokeratin/HRP conjugate, diaminobenzidine (DAB), and stained with hematoxylin. Slides were ready within 8 minutes and were interpreted as positive or negative for metastatic carcinoma. Results were compared with previous intraoperative touch preparations, frozen sections, hematoxylin and eosin (Perm HE), and AEl/3-immunostained permanent sections (Perm CK).Fourteen lymph nodes (19%) in 13 patients tested positive for metastatic carcinoma in Perm HE, the gold standard. RIHC-CK had the highest sensitivity (92%) of the intraoperative tests, compared with touch preparations (64%) and frozen sections (80%). RIHC-CK showed 94% accuracy, compared with 96% (frozen section) and 93% (touch preparation). The RIHC technique took 8 minutes and was easy to perform and interpret.Zymed RIHC is a sensitive method for detecting breast cancer metastases in SLNs. The speed, accuracy, and ease of interpretation of the test allow for recognition of micrometastases (2 mm) that might otherwise be undetectable by current methods of intraoperative evaluation. The prognostic significance and effect on surgical management of micrometastases in SLNs have yet to be determined. |
| Databáze: | OpenAIRE |
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