- citati u SCIndeksu: 0
- citati u CrossRef-u:0
- citati u Google Scholaru:[
 ]
- posete u poslednjih 30 dana:2
- preuzimanja u poslednjih 30 dana:0
|
|
|
2020, vol. 77, br. 2, str. 196-200
|
|
Intraoperativni citološki otisak sentinelnih limfnih čvorova kod bolesnica sa karcinomom dojke - poređenje sa ledenim rezovima
Intraoperative imprint cytology of sentinel lymph nodes in breast cancer patients: Comparation with frozen section
aInstitut za onkologiju Vojvodine, Sremska Kamenica, Srbija + Univerzitet u Novom Sadu, Medicinski fakultet, Srbija bUniverzitet u Novom Sadu, Medicinski fakultet, Srbija + Institut za onkologiju Vojvodine, Sremska Kamenica, Srbija cUniverzitet u Novom Sadu, Medicinski fakultet, Srbija + Klinički centar Vojvodine, Centar za patologiju i histologiju, Novi Sad, Srbija
e-adresa: tatjana.ivkovic-kapicl@mf.uns.ac.rs
Sažetak
Uvod/Cilj. Biopsija limfnog čvora stražara (engl. sentinel lymph node - SLN) je standardna procedura za intraoperativnu procenu statusa aksilarnih limfnih čvorova kod bolesnica sa karcinomom dojke koje imaju klinički negativne limfne čvorove pazušne jame. Pregled SLN se intraoperativno izvodi tehnikama ledenih rezova (engl. frozen section - FS), citološke evaluacije otiska (engl. touch imprint cytology - TIC) i metodom amplifikacije nukleinskih kiselina u jednom koraku. Cilj studije bio je da se uporede i procene pouzdanost i tačnost tehnike FS i TIC kao metoda za pregled SLN kod bolesnica sa karcinomom dojke. Metode. SLN, dobijeni od 101 bolesnice, intraoperativno su pregledani na FS bojenim hematoksilin-eozin (HE) bojenjem i citološkom analizom razmaza dobijenim otiskom limfnih čvorova. Rezultati citološke analize poređeni su sa FS nalazom i trajnim histološkim preparatima. Rezultati. Ukupan broj analiziranih SLN iznosio je 163, u proseku 1,6 (1-4) po bolesnici. Na definitivnim, parafinskim preparatima, metastaze u SLN ustanovljene su kod 19 (19%) bolesnica, dok kod 82 (81%) bolesnice u limfnim čvorovima nije bilo tumora. Senzitivnost i specifičnost za TIC iznosila je 73,7% i 99,3%, dok je za tehniku FS senzitivnost bila 84,2%, a specifičnost 100%. Pozitivna/negativna prediktivna vrednost za TIC je iznosila 93,3%/96,6%, a za metodu FS 100%/97,9%. Zaključak. Naše iskustvo sa metodama TIC i FS u intraoperativnoj proceni statusa SLN kod bolesnica sa karcinomom dojke slično je rezultatima ranije objavljenih studija. Utvrđena je visoka specifičnost za obe metode, ali je senzitivnost tehnike TIC u detekciji metastaza u SLN nešto niža u odnosu na metodu FS. TIC metoda intraoperativnog pregleda SLN može predstavljati pouzdanu alternativu metodi FS zbog jednostavnosti i niske cene.
Abstract
Background/Aim. Sentinel lymph node (SLN) biopsy has been established as the standard of care for axillary staging in patients with invasive breast carcinoma and clinically negative lymph nodes. Intraoperative assessment of sentinel lymph nodes might be done by frozen section (FS), touch imprint cytology (TIC) and one step nucleic acid amplification. The aim of this study was to review our institution's results with SLN biopsy using TIC and FS technique as intraoperative diagnostic tool for breast cancer patients. Methods. SLNs from 101 patients were examined intraoperatively by frozen hematoxylin-eosin (H&E) stain and by touch imprint cytology. Results of TIC were compared with FS and permanent histology sections. Results. The total number of dissected SLNs was 163 with a mean of 1.6 (1-4) per patient. The permanent H&E identified 19 (19%) patients with a sentinel lymph node metastasis and 82 (81%) patients with tumor-free sentinel nodes. The sensitivity/specificity rates were 73.7%/99.3%, respectively for TIC and 84.2%/100%, respectively for FS. Relevant positive/negative predictive values were 93.3%/96.6%, respectively for TIC and 100%/97.9%, respectively for FS. Conclusion. Our experience with TIC and FS for the intraoperative evaluation of SLNs is similar to the findings from previously reported studies. We detected the high specificity for both methods, but TIC technique appeared to be less sensitive than FS in detecting SLN metastases in breast cancer patients. TIC could be recommended as reasonable alternative to frozen section due to its simplicity and low cost.
|
|
|
|
Reference
|
|
  
|
Chicken, D.W., Kocjan, G., Falzon, M., Lee, A.C., Douek, M., Sainsbury, R., Keshtgar, M.R.S. (2006) Intraoperative touch imprint cytology for the diagnosis of sentinel lymph node metastases in breast cancer. British Journal of Surgery, 93(5), 572-576
|
|
|
Creager, A.J., Geisinger, K.R., Perrier, N.D., Shen, P., Shaw, J.A., Young, P.R., Case, D., Levine, E.A. (2004) Intraoperative imprint cytologic evaluation of sentinel lymph nodes for lobular carcinoma of the breast. Annals of Surgery, 239(1), 61-66
|
|
3
|
Edge, S.B., Byrd, D.R., Compton, C.C., Fritz, A.G., Greene, F.L., Trotti, A. (2009) AJCC cancer staging manual. New York: Springer, 419-460, 7th ed
|
|
|
Elliott, R.M., Shenk, R.R., Thompson, C.L., Gilmore, H.L. (2014) Touch preparations for the intraoperative evaluation of sentinel lymph nodes after neoadjuvant therapy have high false-negative rates in patients with breast cancer. Archives of Pathology & Laboratory Medicine, 138(6), 814-818
|
|
|
Elston, C.W., Ellis, I.O. (1991) Pathological prognostic factors in breast cancer. I: The value of histological grade in breast cancer: Experience from large study with long-term follow-up. Histopathology, 19(5), 403-410
|
|
|
Francz, M., Egervari, K., Szollosi, Z. (2011) Intraoperative evaluation of sentinel lymph nodes in breast cancer: Comparison of frozen sections, imprint cytology and immunocytochemistry. Cytopathology, 22(1), 36-42
|
|
|
Giuliano, A.E., Hunt, K.K., Ballman, K.V., Beitsch, P.D., Whitworth, P.W., Blumencranz, P.W. (2011) Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis. JAMA, 305(6), 569-575
|
|
|
Gyorki, D.E., Henderson, M.A. (2010) Significance of sentinel lymph node micrometastases in patients with breast cancer. Journal of Clinical Oncology, 28(9), e139-e139; author reply e141-2
|
|
|
Hoda, S.A., Resetkova, E. (2017) Pathologic examination of breast and lymph node speciments, including sentinel lymph nodes. u: Brogi E., Hoda S.A., Koerner F.C., Rosen P.P. [ur.] Rosen's breast pathology, Philadelphia: Wolters Kluwer Health, 1263-1336, 4 ed
|
|
|
Khanna, R., Bhadani, S., Khanna, S., Pandey, M., Kumar, M. (2011) Touch imprint cytology evaluation of sentinel lymph node in breast cancer. World Journal of Surgery, 35(6), 1254-1259
|
|
|
Krishnamurthy, S., Meric-Bernstam, F., Lucci, A., Hwang, R.F., Kuerer, H.M., Babiera, G., Ames, F.C., Feig, B.W., Ross, M.I., Singletary, E., Hunt, K.K., Bedrosian, I. (2009) A prospective study comparing touch imprint cytology, frozen section analysis, and rapid cytokeratin immunostain for intraoperative evaluation of axillary sentinel lymph nodes in breast cancer. Cancer, 115(7), 1555-1562
|
|
|
Lumachi, F., Marino, F., Zanella, G., Chiara, G.B., Basso, S.M. (2012) Touch imprint cytology and frozen-section analysis for intraoperative evaluation of sentinel nodes in early breast cancer. Anticancer Res, 32(8), 3523-3526
|
|
|
Lyman, G.H., Somerfield, M.R., Bosserman, L.D., Perkins, C.L., Weaver, D.L., Giuliano, A.E. (2017) Sentinel lymph node biopsy for patients with early-stage breast cancer: American society of clinical oncology clinical practice guideline update. Journal of Clinical Oncology, 35(5), 561-564
|
|
|
Maguire, A., Brogi, E. (2016) Sentinel lymph nodes for breast cancer. Histopathology, 68(1), 152-167
|
|
|
Maguire, A., Brogi, E. (2016) Sentinel lymph nodes for breast carcinoma: A paradigm shift. Archives of Pathology & Laboratory Medicine, 140(8), 791-798
|
|
|
Motomura, K., Inaji, H., Komoike, Y., Kasugai, T., Nagumo, S., Noguchi, S., Koyama, H. (2000) Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery. British Journal of Surgery, 87(5), 597-601
|
|
|
Omranipour, R., Jaleeefar, A., Mirafsharieh, A., Assasnik, P. (2014) Intraoperative evaluation of sentinel lymph nodes by touch imprint cytology technique in breast cancer patients. Annual Research & Review in Biology, 4(24), 3751-3757
|
|
|
Pérez-Sánchez, V.M., Vela-Chávez, T.A., Villarreal-Colin, P., Bargalló-Rocha, E., Ramírez-Ugalde, M.T., Munoz-Gonzalez, D., Zeichner-Gancz, I. (2010) Intraoperative touch imprint cytology of sentinel lymph nodes in breast cancer: Experience at a tertiary care center in Mexico. Medical Oncology, 27(2), 233-236
|
|
|
Richards, A.D.M., Lakhani, S.R., James, D.T., Ung, O.A. (2013) Intraoperative imprint cytology for breast cancer sentinel nodes: Is it worth it?. ANZ Journal of Surgery, 83(7-8), 539-544
|
|
|
Safai, A., Razeghi, A., Monabati, A., Azarpira, N., Talei, A. (2012) Comparing touch imprint cytology, frozen section analysis, and cytokeratin immunostaining for intraoperative evaluation of axillary sentinel lymph nodes in breast cancer. Indian J Pathol Microbiol, 55(2), 183-186
|
|
|
Schrenk, P., Rieger, R., Shamiyeh, A., Wayand, W. (2000) Morbidity following sentinel lymph node biopsy versus axillary lymph node dissection for patients with breast carcinoma. Cancer, 88(3), 608-614
|
|
|
Tew, K., Irwig, L., Matthews, A., Crowe, P., Macaskill, P. (2005) Meta-analysis of sentinel node imprint cytology in breast cancer. British Journal of Surgery, 92(9), 1068-1080
|
|
|
|
|