Evaluation of intraoperative molecular assay in sentinel lymph node biopsy from breast cancer patients.
- Author:
Da-Li LI
1
;
Wen-Tao YANG
;
Xu CAI
;
Xiao-Li XU
;
Wei-Ping XU
;
Jia-Jian CHEN
;
Ben-Long YANG
;
Jiong WU
;
Da-Ren SHI
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Breast Neoplasms; metabolism; pathology; surgery; Breast Neoplasms, Male; metabolism; pathology; surgery; Carcinoma, Ductal, Breast; metabolism; pathology; surgery; Carcinoma, Intraductal, Noninfiltrating; metabolism; pathology; surgery; Female; Humans; Intraoperative Period; Keratin-19; metabolism; Lymph Nodes; metabolism; pathology; surgery; Lymphatic Metastasis; Male; Mammaglobin A; Mastectomy; methods; Middle Aged; Neoplasm Proteins; metabolism; Sensitivity and Specificity; Sentinel Lymph Node Biopsy; methods; Uteroglobin; metabolism
- From: Chinese Journal of Pathology 2010;39(11):729-733
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVEto evaluate the application of GeneSearch(TM) breast lymph node assay in intraoperative detection of metastases in sentinel lymph node (SLN) from breast cancer patients.
METHODSa total of 225 SLN from 88 patients was prospectively studied. Each SLN was cut into 2 mm slabs which were examined by intraoperative imprint cytology (IIC) first, followed by GeneSearch assay and post-operative serial sectioning. GeneSearch used real-time fluorescence quantitative RT-PCR technology to detect the expression of CK19 and mammaglobin in SLN. The results of GeneSearch assay were correlated with those of IIC and post-operative serial sectioning.
RESULTSamongst the 88 cases studied, 225 SLNs were found, and obvious metastatic carcinoma cells were identified in 27 SLNs and micrometastasis in 9 SLNs. One hundred and eight-nine SLNs were considered as "negative" (with "isolated tumor cells" present in 5 SLNs). The turn-around time of intraoperative GeneSearch assay ranged from 35 to 45 minutes (mean = 40 minutes). The concordance rate between GeneSearch assay and post-operative serial sectioning was 95.6% (215/225), with a sensitivity of 86.1% (31/36), compared with 94.7% (213/225) and 72.2% (26/36) respectively for IIC. The size of metastatic foci correlated with the Ct value of CK19 and mammaglobin (P < 0.01).
CONCLUSIONSGeneSearch assay for intraoperative detection of metastase in SLN has a satisfactory performance and demonstrates a relatively higher sensitivity than IIC. The potential clinical application still requires further evaluation of larger number of cases.
