Sentinel Lymph Node Mapping in the Management of Colorectal Cancer: Preliminary Report
| Autor: | Fabrizio Zanconati, Monica Scaramucci, Gennaro Liguori, Tiziana Ciutto, Alessandro Balani, Angelo Turoldo, A Leggeri, Roseano M |
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| Rok vydání: | 2003 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Pathology Colorectal cancer medicine.medical_treatment 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Humans Stage (cooking) Lymph node Aged Neoplasm Staging Aged 80 and over Sentinel Lymph Node Biopsy business.industry General Medicine Middle Aged Sentinel node medicine.disease Primary tumor medicine.anatomical_structure Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis Female Lymphadenectomy Radiology Lymph Colorectal Neoplasms business Ex vivo |
| Zdroj: | Tumori Journal. 89:412-416 |
| ISSN: | 2038-2529 0300-8916 |
| DOI: | 10.1177/030089160308900413 |
| Popis: | Aim and background The problem of understaging the lymph node status in colorectal cancer because of missed micrometastases led authors to investigate the role of sentinel node (SN) mapping also in colorectal malignancies. The aim of this study was to evaluate the feasibility of the technique and to correlate the results with some characteristics of the primary tumor. Methods Sentinel lymph node mapping was performed in 23 patients who underwent a standard lymphadenectomy for colorectal cancer. The vital dye Patent Blue had been injected into the peritumoral subserosa in vivo in 17 cases and ex vivo in seven, including one case where the in vivo method did not allow to identify the sentinel node. The nodes that took up the dye were removed and analyzed with standard hematoxylin-eosin staining in serial sections. Immunohistochemistry (AE1-AE3 cytokeratin markers) was performed in hematoxylin-eosin-negative nodes. SN status was related to the status of the other lymph nodes in the surgical specimen analyzed with the standard technique and to the following characteristics of the primary tumor: stage, grade and diameter. Results The in vivo technique allowed to identify the SN in 16/17 cases (94.1%), the ex vivo technique in 7/7. A total of 336 lymph nodes dissected from the surgical specimens was analyzed, with an average of 14.6 nodes per patient (range, 7-35). Of these nodes 58 were SNs, with an average of 2.5 nodes per patient (range, 1-8). In the 19 cases where the SN was tumor negative, the non-SNs were also negative (specificity: 100%), whereas in the four cases where the non-SNs were positive, in two cases the SN was positive and in two cases of pT3 rectal carcinoma the SN was negative (sensitivity: 50%). Immunohistochemistry did not modify the negative results of the standard hematoxylin-eosin evaluation. Conclusions The method used to identify the SN using vital dye proved to be easy to use both in vivo and ex vivo and allowed to identify the SN in all cases. The preliminary results indicate that there is a risk of false negative findings and therefore further studies are required to improve the sensitivity and the specificity of the technique and to evaluate the role of SN mapping in colorectal cancer management. |
| Databáze: | OpenAIRE |
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