Novel diagnostic procedure for determining metastasis to sentinel lymph nodes in breast cancer using a semi-dry dot-blot method
Corresponding Author
Ryota Otsubo
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
R.O. and M.O. contributed equally to this work
Correspondence to: Takeshi Nagayasu, Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki 852-8523, Japan, Tel.: +81-95-819-7304, Fax: +81-95-819-7306, E-mail: [email protected]Search for more papers by this authorCorresponding Author
Masahiro Oikawa
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Correspondence to: Takeshi Nagayasu, Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki 852-8523, Japan, Tel.: +81-95-819-7304, Fax: +81-95-819-7306, E-mail: [email protected]Search for more papers by this authorHiroshi Hirakawa
Department of Gynecology, Aiyuukai Memorial Hospital, Chiba, Japan
Search for more papers by this authorKenichiro Shibata
Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Search for more papers by this authorKuniko Abe
Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorTomayoshi Hayashi
Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorNaoe Kinoshita
Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorKazuto Shigematsu
Department of Pathology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Search for more papers by this authorToshiko Hatachi
Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Search for more papers by this authorHiroshi Yano
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorMegumi Matsumoto
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorKatsunori Takagi
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorTomoshi Tsuchiya
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorKoichi Tomoshige
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorMasahiro Nakashima
Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
Search for more papers by this authorHideki Taniguchi
Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Search for more papers by this authorTakeyuki Omagari
Department of Surgery, St. Francis Hospital, Nagasaki, Japan
Search for more papers by this authorNoriaki Itoyanagi
Department of Surgery, St. Francis Hospital, Nagasaki, Japan
Search for more papers by this authorTakeshi Nagayasu
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorCorresponding Author
Ryota Otsubo
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
R.O. and M.O. contributed equally to this work
Correspondence to: Takeshi Nagayasu, Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki 852-8523, Japan, Tel.: +81-95-819-7304, Fax: +81-95-819-7306, E-mail: [email protected]Search for more papers by this authorCorresponding Author
Masahiro Oikawa
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Correspondence to: Takeshi Nagayasu, Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, 1-7-1 Sakamoto, Nagasaki 852-8523, Japan, Tel.: +81-95-819-7304, Fax: +81-95-819-7306, E-mail: [email protected]Search for more papers by this authorHiroshi Hirakawa
Department of Gynecology, Aiyuukai Memorial Hospital, Chiba, Japan
Search for more papers by this authorKenichiro Shibata
Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Search for more papers by this authorKuniko Abe
Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorTomayoshi Hayashi
Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorNaoe Kinoshita
Department of Pathology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorKazuto Shigematsu
Department of Pathology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Search for more papers by this authorToshiko Hatachi
Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Search for more papers by this authorHiroshi Yano
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorMegumi Matsumoto
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorKatsunori Takagi
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorTomoshi Tsuchiya
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorKoichi Tomoshige
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorMasahiro Nakashima
Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
Search for more papers by this authorHideki Taniguchi
Department of Surgery, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
Search for more papers by this authorTakeyuki Omagari
Department of Surgery, St. Francis Hospital, Nagasaki, Japan
Search for more papers by this authorNoriaki Itoyanagi
Department of Surgery, St. Francis Hospital, Nagasaki, Japan
Search for more papers by this authorTakeshi Nagayasu
Department of Surgical Oncology, Nagasaki University Hospital, Nagasaki, Japan
Search for more papers by this authorConflicts of interest: Nothing to report
Abstract
We developed an easy, quick and cost-effective detection method for lymph node metastasis called the semi-dry dot-blot (SDB) method, which visualizes the presence of cancer cells with washing of sectioned lymph nodes by anti-pancytokeratin antibody, modifying dot-blot technology. We evaluated the validity and efficacy of the SDB method for the diagnosis of lymph node metastasis in a clinical setting (Trial 1). To evaluate the validity of the SDB method in clinical specimens, 180 dissected lymph nodes from 29 cases, including breast, gastric and colorectal cancer, were examined. Each lymph node was sliced at the maximum diameter and the sensitivity, specificity and accuracy of the SDB method were determined and compared with the final pathology report. Metastasis was detected in 32 lymph nodes (17.8%), and the sensitivity, specificity and accuracy of the SDB method were 100, 98.0 and 98.3%, respectively (Trial 2). To evaluate the efficacy of the SDB method in sentinel lymph node (SLN) biopsy, 174 SLNs from 100 cases of clinically node-negative breast cancer were analyzed. Each SLN was longitudinally sliced at 2-mm intervals and the sensitivity, specificity, accuracy and time required for the SDB method were determined and compared with the intraoperative pathology report. Metastasis was detected in 15 SLNs (8.6%), and the sensitivity, specificity, accuracy and mean required time of the SDB method were 93.3, 96.9, 96.6 and 43.3 min, respectively. The SDB method is a novel and reliable modality for the intraoperative diagnosis of SLN metastasis.
Abstract
What's new?
Missed detection of metastases in sentinel lymph node biopsy for node-negative breast cancer, which is notoriously difficult to diagnose, may lead to additional surgeries. So, to improve detection rates, the authors of this study developed a technique known as the semi-dry dot-blot (SDB) method, which employs anti-pancytokeratin antibody to identify cancer cells in lymph node tissue. Clinical results reported here show that the SBD method is accurate at least 98 percent of the time for several malignancies. In nodenegative breast cancer, accuracy was a remarkable 96.6 percent. The short time required for the test could help speed diagnosis.
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