连续病理切片检测乳腺癌前哨淋巴结微转移的研究

Study on detection of micrometastases in sentinel lymph node of breast cancer by serial section

目的探讨连续切片(serial section,SS)对乳腺癌前哨淋巴结(sentinel lymph node,SLN)微转移(micrometastases,MM)的诊断价值。方法对118例常规病理诊断阴性的212枚SLN以不同间距行连续切片后HE染色(SS-HE),分析SLN微转移与临床各因素的关系,确定SS检测微转移的最佳间距。结果 118例患者通过连续切片HE染色检测出微转移14例(11.9%)。212枚SLN中,连续切片HE染色,间距100μm、200μm、300μm、400μm和500μm SS-HE淋巴结微转移的检出率分别为8.0%(17/212)、6.6%(14/212)、3.8%(8/212)、2.4%(5/212)、1.4%(3/212);间距100μm SLN微转移检出率与间距200μm、300μm相比差异无统计学意义(P>0.05),但与400μm、500μm相比差异有统计学意义(P<0.05)。研究发现SLN微转移与年龄、肿瘤大小、肿瘤位置、病理分期、病理类型、受体状况以及HER-2、Ki-67表达无关(均P>0.05)。结论 SS-HE能提高SLN微转移的检出率。

Objective To explore the diagnostic value of serial section in detecting sentinel lymph nodes（ SLNs） micrometastases of breast cancer. Methods A total of 212 SLNs from 118 patients identified negative by pathology were serially cut with different intervals and then stained by hematoxylin and eosin（ HE） to screen the appropriate space for detecting micrometastases. The relations between SLNs micrometastases and clinical factors were analyzed. Results In the 118 SLNs negative patients,there were 14（11. 9%） patients with micrometastases. The detection rate of occult metastases at 100 μm,200 μm,300 μm,400 μm,500 μm intervals was 8. 0%（17 /212）,6. 6%（14 /212）,3. 8%（8 /212）,2. 4%（5 /212）,1. 4%（3 /212）. The positive rates of occult metastases had no significant difference at the space interval of 100 μm and 200 μm,300 μm（ P 〉 0. 05）,but it was significantly higher than those at the space intervals of 400 μm,500 μm（P〈 0. 05）. Conclusion SS-HE can improve the detection rate of SLN micrometastases.