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01-03-2012 | Gastrointestinal Oncology

Precise Pathologic Examination Decreases the False-Negative Rate of Sentinel Lymph Node Biopsy in Gastric Cancer

Authors: Hye Seung Lee, MD, PhD, Hee Eun Lee, MD, PhD, Do Joong Park, MD, PhD, Young Soo Park, MD, PhD, Hyung-Ho Kim, MD, PhD

Published in: Annals of Surgical Oncology | Issue 3/2012

Abstract

Background

Gastric cancer has been identified as a target for sentinel lymph node (SLN) navigational surgery. Although accurate evaluation of SLNs is essential for applying the SLN concept to gastric cancer surgery, there is no standardized pathologic examination protocol for SLNs in gastric cancer.

Methods

A total of 231 SLNs from 69 patients with cT1–2, N0 gastric cancer were prospectively examined in this study. During the operation, SLNs were sliced at 2-mm intervals, and frozen sections were analyzed by hematoxylin and eosin (HE) staining in 35 patients or HE staining with rapid immunohistochemistry (IHC) for pancytokeratin (CK) in 34 patients. HE staining and CK IHC were performed postoperatively on each remaining SLN. Non-SLNs were evaluated with 2 levels of HE slides and 1 CK IHC.

Results

Of 35 patients, metastasis was identified in 10 patients by intraoperative HE staining, and in 12 patients by postoperative HE staining and CK IHC. Two patients had isolated tumor cells (ITCs) detectable by postoperative CK IHC; these patients had non-SLN metastasis. We enrolled another 34 patients and examined 147 SLNs by frozen HE and rapid IHC. In this cohort, 26 patients with negative SLNs by intraoperative examination did not have non-SLN metastasis even after deeper sectioning and CK IHC of non-SLNs (sensitivity, 100%; false negative value, 0%).

Conclusions

Our study indicated that precise and detailed intraoperative examination decreases the false-negative rate of SLN biopsy. ITCs in SLNs should not be overlooked, and rapid IHC can be helpful for detecting ITCs intraoperatively.

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Title: Precise Pathologic Examination Decreases the False-Negative Rate of Sentinel Lymph Node Biopsy in Gastric Cancer
Authors: Hye Seung Lee, MD, PhD
Hee Eun Lee, MD, PhD
Do Joong Park, MD, PhD
Young Soo Park, MD, PhD
Hyung-Ho Kim, MD, PhD
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 3/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-2106-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Precise Pathologic Examination Decreases the False-Negative Rate of Sentinel Lymph Node Biopsy in Gastric Cancer

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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