前哨淋巴结活检术中触摸印迹细胞学(TIC)在乳腺癌:经验的一个小容量中心。

IF 0.4 Q4 SURGERY Giornale di Chirurgia Pub Date : 2020-01-01
A Marano, B Sodano, C Vitiello, A M Martini, F Baldassarre, A Siciliano, G Iannaci
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引用次数: 0

摘要

虽然被认为是治疗EBC的金标准,前哨淋巴结活检仍然是一个有争议的问题。前哨淋巴结阳性的处理及术中组织检查的必要性是讨论最多的话题。在这项研究中,我们回顾性评估了2011年1月至2018年12月期间359例前哨淋巴结活检在乳腺癌治疗中的病例,重点研究了TIC技术在术中检查中的应用。结果为12.8%的“假阴性”率,其中大转移灶仅为4.2%,总体敏感性为68.4%(大转移灶:86%;微转移:11%),总体特异性为98,7%,总体准确性为89,7%。术中检查SLN可以减少延迟手术程序,并提高乳房切除术的治疗安全性。TIC方法可以被认为是有效的、简单的和快速的识别大转移,也可以避免分期不足。考虑到最近的证据大大减少了这些病例中ALND的适应症,对微转移的低敏感性并不是一个限制。需要进一步的试验和nomogram和SCORE的可能验证来确定低风险病例,从而明确忽略ALND和/或甚至SLNB本身。
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Sentinel lymph node biopsy with intraoperative touch imprint cytology (TIC) in breast cancer: experience of a mild-volume center.

Although considered the gold standard in treatment of EBC, sentinel node biopsy still remains a debated issue. What to do in case of positive sentinel node and the need of intraoperative histological examination are the most topics under discussion. In this study we have retrospectively evaluate our case series of 359 sentinel node biopsy in the managing of breast cancer from January 2011 to December 2018, focusing on the TIC technique for performing intraoperative examination. It results in 12,8% "FALSE NEGATIVE" rate, in which only 4,2% in macrometastases, with an overall sensitivity of 68,4% (macrometastases: 86%; micrometastases: 11%), overall specificity of 98,7% and an overall accuracy of 89,7%. The intraoperative examination of SLN allows to reduce delayed surgery procedures and greater therapeutic safety in case of mastectomy. The TIC method can be considered valid, simple and rapid in identifying macrometastases, also allowing to avoid under-staging. The low sensitivity for micrometastases is not a limit, considering that recent evidence has drastically reduced the indications for ALND in these cases. Further ongoing trials and the possible validation of NOMOGRAMMS and SCORE are necessary to identify low risk cases in which to definitively omit the ALND and/or even the SLNB itself.

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来源期刊
CiteScore
1.10
自引率
0.00%
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期刊介绍: Il Giornale di Chirurgia pubblica contributi che propongono le diverse tecniche su patologia chirurgiche di attualità. Pubblica articoli originali, casistica clinica, metodi, tecniche, terapia farmacologica pre-operatoria e post-chirurgica, ed articoli inerenti la descrizione di tecniche chirurgiche.
期刊最新文献
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