Purpose: Most important factor affecting prognosis of breast cancer is axillary nodal involvement. Several studies evaluated the accuracy of Sentinel lymph node biopsy in breast cancer patients post neoadjuvant chemot...Purpose: Most important factor affecting prognosis of breast cancer is axillary nodal involvement. Several studies evaluated the accuracy of Sentinel lymph node biopsy in breast cancer patients post neoadjuvant chemotherapy. In this study, we will examine accuracy and feasibility of using Sentinel lymph node biopsy in predicting axillary lymph node status in breast cancer patients after neoadjuvant chemotherapy. Methods: 45 female patients with resectable, nonmetastatic breast carcinoma cases who received neoadjuvant chemotherapy were enrolled in this study according to the routine Mansoura Oncology Center—guidelines of management of breast cancer. Methylene blue dye used for detection of Sentinel lymph node. Results: Successful Sentinel lymph node detection was 82.2%. Skin involvement (T4 disease) were linked to a low identification (P = 0.005). False negative rate equals 11/27 = (40.7%).With advancement of the stage of the tumor, the incidence of false negative results increases significantly (p = 0.012) with 95% confidence interval;1.2 - 5.4. Conclusion: Sentinel lymph node should be adopted to be the standard method for axillary staging with T1-3 tumors after receiving neoadjuvant chemotherapy, in T4 patients, it is associated with low detection rate & high false negative rate making it doubtful technique for axillary staging.展开更多
Objective： The aim of this study was to investigate the feasibility of sentinel lymph node biopsy （SLNB） in colorectal cancer. Methods： Twenty patients of colorectal cancer were enrolled in this study. Endoscopic ...Objective： The aim of this study was to investigate the feasibility of sentinel lymph node biopsy （SLNB） in colorectal cancer. Methods： Twenty patients of colorectal cancer were enrolled in this study. Endoscopic injection submucosally of ^99m Tc-DX was performed around the primary tumor 3 h before operation. Immediately after laparotomy, methylene blue was injected into subserosal layer adjacent to the tumor. Sentinel lymph nodes （SLNs） were defined as blue stained nodes or （and） those containing 10 times more radioactivity than surrounding tissue with a y probe, all resected nodes were examined postoperatively by routine rapid frozen examination and HE stain. The diagnostic nodes metastasis states and false-negative rate of regional lymph node status on the basis of SLNs were calculated respectively. Results： SLNs were detected in 16 of 20 patients with a successful detection rate of 80%, the number of SLNs ranged from 1 to 3, with a mean value of 2.4 per case, metastasis rate of SLNs were 37.5% （18/48）, the diagnostic sensitivity was 80% （16/20）, the diagnostic accuracy was 83.3% （15/18）, the false-negative rate was 20% （4/20）. Conclusion： The SLN concept is validated in colorectal cancer. Com- bined-agent SLN mapping is an accurate diagnostic procedure for detecting lymph node metastasis in patients with colorectal cancer and may indicate rational extent of lymphadenectomy for colorectal cancer.展开更多
Sentinel lymph node(SLN) biopsy has become the gold standard for patients with melanoma and breast cancer but it's clinical application in other solid tumor types such as cancers of the esophagus, stomach, colon a...Sentinel lymph node(SLN) biopsy has become the gold standard for patients with melanoma and breast cancer but it's clinical application in other solid tumor types such as cancers of the esophagus, stomach, colon and rectum, head and neck, penis, uterine cervix and endometrium has been somewhat limited. Commonly used mapping techniques utilizing the combination of radiocolloid and blue dye may result in reduced SLN detection and increased false negative rates when applied to cancers with more complex lymphatic drainage patterns. Novel localization techniques includingnear infrared fluorescence, high resolution imaging and molecular targeted agents have been developed to address the limitations of conventional SLN detection practices in many solid tumor types. This article reviews the indications, techniques and detection rates for SLN biopsy in several different solid tumor types as well as the promising novel techniques created to address the contemporary limitations of this procedure.展开更多
In recent years the development of extremely accurate techniques for the removal of lymph nodes has been seen, such as the Sentinel Lymph Node Biopsy (SLNB) technique. The technique is based on the staggered progressi...In recent years the development of extremely accurate techniques for the removal of lymph nodes has been seen, such as the Sentinel Lymph Node Biopsy (SLNB) technique. The technique is based on the staggered progression occurring in the lymphatic drainage of neoplasias, and is currently the main prognostic and diagnostic factor in women suffering from mammary carcinoma. This research aims at assessing the sentinel lymph node biopsy accuracy in female dogs suffering from mammary carcinoma. Forty-one dogs with cytological diagnosis of the tumor were used in the research. After injecting a Patent Blue V dye, mastectomy was conducted jointly with lymphadenectomy (for both sentinel and non-sentinel lymph nodes). The material was then serially sectioned and microscopically evaluated by routine H&E stain and immunohistochemical study with the markers for pancytokeratin AE1/AE3 and myoepithelial cells CK14. The study revealed that 46.3% (19/41) of the animals presented nodal metastasis. The sensitivity and specificity values found for SLNB were respectively 89.5% and 100%, with a kappa coefficient of 0.90 and p < 0.0001. Therefore, the SLNB technique offers high sensitivity in the early detection of metastases, allowing higher precision in the staging of oncological patients and, therefore, offering higher chances of survival.展开更多
Background:Methylene blue is the most commonly used tracer for sentinel lymph node(SLN)biopsy(SLNB)in China.This study aimed to investigate the feasibility of clinical application of SLNB using methylene blue dye(MBD)...Background:Methylene blue is the most commonly used tracer for sentinel lymph node(SLN)biopsy(SLNB)in China.This study aimed to investigate the feasibility of clinical application of SLNB using methylene blue dye(MBD)for early breast cancer and the prognosis of patients with different SLN and non-SLN statuses.Methods:We retrospectively analyzed the clinicopathological data of patients with early breast cancer treated at the Peking University First Hospital between 2013 and 2018.We calculated the SLN identification rate(IR)in SLNB with MBD and the false-negative rate(FNR),and analyzed the prognosis of patients with different SLN and non-SLN statuses using Kaplan-Meier curves.Results:Between January 2013 and December 2018,1603 patients with early breast cancer underwent SLNB with MBD.The SLN IR was 95.8%(1536/1603).Two SLNs(median)were detected per patient.There were significant differences in FNR between patients with SLN micrometastasis and macrometastasis(19.0%vs.4.5%,χ^(2)=12.771,P<0.001).Chi-square test showed that there were significant differences in SLN successful detection rates among patients with different vascular tumor embolism status(96.3%vs.90.8%,χ^(2)=9.013,P=0.003)and tumor(T)stages(96.6%vs.94.1%,χ^(2)=5.189,P=0.023).Multivariate analysis showed that vascular tumor embolism was the only independent factor for SLN successful detection(odds ratio:0.440,95%confidence interval:0.224-0.862,P=0.017).Survival analysis showed a significant difference in disease-free survival(DFS)between patients with non-SLN metastasis and patients without non-SLN metastasis(P=0.006).Conclusion:Our single-center data show that,as a commonly used tracer in SLNB in China,MBD has an acceptable SLN IR and a low FNR in frozen sections.This finding is consistent with reports of dual tracer-guided SLNB.Positive SLNs with non-SLN metastasis are associated with DFS.展开更多
目的:染料法是乳腺癌前哨淋巴结活检的方法之一,其成功率受多种因素影响。本研究旨在探讨影响染料法乳腺癌前哨淋巴结活检成功率的相关因素。方法:2007年1月—2008年8月乳腺癌患者141例,于乳晕周围注射1%亚甲蓝,实施前哨淋巴结活检,随...目的:染料法是乳腺癌前哨淋巴结活检的方法之一,其成功率受多种因素影响。本研究旨在探讨影响染料法乳腺癌前哨淋巴结活检成功率的相关因素。方法:2007年1月—2008年8月乳腺癌患者141例,于乳晕周围注射1%亚甲蓝,实施前哨淋巴结活检,随后行腋窝淋巴结清扫,常规HE染色进行病理诊断。采用非条件logistic回归进行单因素和多因素分析。结果:126例患者检出前哨淋巴结,15例检测失败。前哨淋巴结活检成功率89.4%,假阴性率为6.82%。单因素分析结果显示,活检成功率与患者年龄、体质量指数(body mass index,BMI)、肿瘤大小、术前腋窝淋巴结状态、肿瘤分级及腋窝淋巴结阳性数≥4枚显著相关。多因素分析结果显示,年龄(OR=4.587,P=0.024)、BMI(OR=4.882,P=0.011)及腋窝淋巴结阳性数≥4枚(OR=3.143,P=0.013)是前哨淋巴结活检成功率的独立影响因素。结论:亚甲蓝示踪法是乳腺癌前哨淋巴结活检的可靠方法,其成功率与患者年龄、BMI和腋窝淋巴结转移数相关。展开更多
文摘Purpose: Most important factor affecting prognosis of breast cancer is axillary nodal involvement. Several studies evaluated the accuracy of Sentinel lymph node biopsy in breast cancer patients post neoadjuvant chemotherapy. In this study, we will examine accuracy and feasibility of using Sentinel lymph node biopsy in predicting axillary lymph node status in breast cancer patients after neoadjuvant chemotherapy. Methods: 45 female patients with resectable, nonmetastatic breast carcinoma cases who received neoadjuvant chemotherapy were enrolled in this study according to the routine Mansoura Oncology Center—guidelines of management of breast cancer. Methylene blue dye used for detection of Sentinel lymph node. Results: Successful Sentinel lymph node detection was 82.2%. Skin involvement (T4 disease) were linked to a low identification (P = 0.005). False negative rate equals 11/27 = (40.7%).With advancement of the stage of the tumor, the incidence of false negative results increases significantly (p = 0.012) with 95% confidence interval;1.2 - 5.4. Conclusion: Sentinel lymph node should be adopted to be the standard method for axillary staging with T1-3 tumors after receiving neoadjuvant chemotherapy, in T4 patients, it is associated with low detection rate & high false negative rate making it doubtful technique for axillary staging.
文摘Objective： The aim of this study was to investigate the feasibility of sentinel lymph node biopsy （SLNB） in colorectal cancer. Methods： Twenty patients of colorectal cancer were enrolled in this study. Endoscopic injection submucosally of ^99m Tc-DX was performed around the primary tumor 3 h before operation. Immediately after laparotomy, methylene blue was injected into subserosal layer adjacent to the tumor. Sentinel lymph nodes （SLNs） were defined as blue stained nodes or （and） those containing 10 times more radioactivity than surrounding tissue with a y probe, all resected nodes were examined postoperatively by routine rapid frozen examination and HE stain. The diagnostic nodes metastasis states and false-negative rate of regional lymph node status on the basis of SLNs were calculated respectively. Results： SLNs were detected in 16 of 20 patients with a successful detection rate of 80%, the number of SLNs ranged from 1 to 3, with a mean value of 2.4 per case, metastasis rate of SLNs were 37.5% （18/48）, the diagnostic sensitivity was 80% （16/20）, the diagnostic accuracy was 83.3% （15/18）, the false-negative rate was 20% （4/20）. Conclusion： The SLN concept is validated in colorectal cancer. Com- bined-agent SLN mapping is an accurate diagnostic procedure for detecting lymph node metastasis in patients with colorectal cancer and may indicate rational extent of lymphadenectomy for colorectal cancer.
文摘Sentinel lymph node(SLN) biopsy has become the gold standard for patients with melanoma and breast cancer but it's clinical application in other solid tumor types such as cancers of the esophagus, stomach, colon and rectum, head and neck, penis, uterine cervix and endometrium has been somewhat limited. Commonly used mapping techniques utilizing the combination of radiocolloid and blue dye may result in reduced SLN detection and increased false negative rates when applied to cancers with more complex lymphatic drainage patterns. Novel localization techniques includingnear infrared fluorescence, high resolution imaging and molecular targeted agents have been developed to address the limitations of conventional SLN detection practices in many solid tumor types. This article reviews the indications, techniques and detection rates for SLN biopsy in several different solid tumor types as well as the promising novel techniques created to address the contemporary limitations of this procedure.
文摘In recent years the development of extremely accurate techniques for the removal of lymph nodes has been seen, such as the Sentinel Lymph Node Biopsy (SLNB) technique. The technique is based on the staggered progression occurring in the lymphatic drainage of neoplasias, and is currently the main prognostic and diagnostic factor in women suffering from mammary carcinoma. This research aims at assessing the sentinel lymph node biopsy accuracy in female dogs suffering from mammary carcinoma. Forty-one dogs with cytological diagnosis of the tumor were used in the research. After injecting a Patent Blue V dye, mastectomy was conducted jointly with lymphadenectomy (for both sentinel and non-sentinel lymph nodes). The material was then serially sectioned and microscopically evaluated by routine H&E stain and immunohistochemical study with the markers for pancytokeratin AE1/AE3 and myoepithelial cells CK14. The study revealed that 46.3% (19/41) of the animals presented nodal metastasis. The sensitivity and specificity values found for SLNB were respectively 89.5% and 100%, with a kappa coefficient of 0.90 and p < 0.0001. Therefore, the SLNB technique offers high sensitivity in the early detection of metastases, allowing higher precision in the staging of oncological patients and, therefore, offering higher chances of survival.
基金Beijing Medical Award Foundation(No.YXJL-2016-0040-0065)Beijing Medical Award Foundation"Clinical efficacy of liquid biopsy for breast cancer"(No.2017-2019)+2 种基金Beijing Medical Award Foundation"Precision medical research on breast cancer"Beijing Medical Award Foundation Youth Program(No.2018-0304)National Key R&D Program of China(No.2016YFC0901302)。
文摘Background:Methylene blue is the most commonly used tracer for sentinel lymph node(SLN)biopsy(SLNB)in China.This study aimed to investigate the feasibility of clinical application of SLNB using methylene blue dye(MBD)for early breast cancer and the prognosis of patients with different SLN and non-SLN statuses.Methods:We retrospectively analyzed the clinicopathological data of patients with early breast cancer treated at the Peking University First Hospital between 2013 and 2018.We calculated the SLN identification rate(IR)in SLNB with MBD and the false-negative rate(FNR),and analyzed the prognosis of patients with different SLN and non-SLN statuses using Kaplan-Meier curves.Results:Between January 2013 and December 2018,1603 patients with early breast cancer underwent SLNB with MBD.The SLN IR was 95.8%(1536/1603).Two SLNs(median)were detected per patient.There were significant differences in FNR between patients with SLN micrometastasis and macrometastasis(19.0%vs.4.5%,χ^(2)=12.771,P<0.001).Chi-square test showed that there were significant differences in SLN successful detection rates among patients with different vascular tumor embolism status(96.3%vs.90.8%,χ^(2)=9.013,P=0.003)and tumor(T)stages(96.6%vs.94.1%,χ^(2)=5.189,P=0.023).Multivariate analysis showed that vascular tumor embolism was the only independent factor for SLN successful detection(odds ratio:0.440,95%confidence interval:0.224-0.862,P=0.017).Survival analysis showed a significant difference in disease-free survival(DFS)between patients with non-SLN metastasis and patients without non-SLN metastasis(P=0.006).Conclusion:Our single-center data show that,as a commonly used tracer in SLNB in China,MBD has an acceptable SLN IR and a low FNR in frozen sections.This finding is consistent with reports of dual tracer-guided SLNB.Positive SLNs with non-SLN metastasis are associated with DFS.
文摘目的:染料法是乳腺癌前哨淋巴结活检的方法之一,其成功率受多种因素影响。本研究旨在探讨影响染料法乳腺癌前哨淋巴结活检成功率的相关因素。方法:2007年1月—2008年8月乳腺癌患者141例,于乳晕周围注射1%亚甲蓝,实施前哨淋巴结活检,随后行腋窝淋巴结清扫,常规HE染色进行病理诊断。采用非条件logistic回归进行单因素和多因素分析。结果:126例患者检出前哨淋巴结,15例检测失败。前哨淋巴结活检成功率89.4%,假阴性率为6.82%。单因素分析结果显示,活检成功率与患者年龄、体质量指数(body mass index,BMI)、肿瘤大小、术前腋窝淋巴结状态、肿瘤分级及腋窝淋巴结阳性数≥4枚显著相关。多因素分析结果显示,年龄(OR=4.587,P=0.024)、BMI(OR=4.882,P=0.011)及腋窝淋巴结阳性数≥4枚(OR=3.143,P=0.013)是前哨淋巴结活检成功率的独立影响因素。结论:亚甲蓝示踪法是乳腺癌前哨淋巴结活检的可靠方法,其成功率与患者年龄、BMI和腋窝淋巴结转移数相关。
