Diagnosis comparison of intraoperative imprint cytology and frozen section for sentinel lymph node metastasis in breast cancer
10.3760/cma.j.issn.1006-9801.2018.10.009
- VernacularTitle:术中印片细胞学与冷冻切片对乳腺癌前哨淋巴结转移诊断价值的比较
- Author:
Xiaojun ZHANG
1
;
Lina HU
;
Li LI
;
Fan GUO
;
Jinnan GAO
Author Information
1. 山西医学科学院 山西大医院 乳腺外科
- Keywords:
Breast neoplasms;
Sentinel lymph node biopsy;
Frozen section;
Imprint cytology
- From:
Cancer Research and Clinic
2018;30(10):686-689
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate whether intraoperative imprint cytology can be used as a diagnostic method of sentinel lymph node metastasis for breast cancer patients in China. Methods A total of 154 breast cancer patients diagnosed histologically as ductal carcinoma in situ or T1-3N0M0 invasive breast cancer who underwent intraoperative sentinel lymph node biopsy from July 2012 to August 2015 in Shanxi Dayi Hospital were enrolled. The sentinel lymph node was detected by using standard dual tracer method. Intraoperative diagnosis was performed with imprint cytology as well as frozen section, and the final diagnosis was assessed by using paraffin pathology after surgery. Results The area under the receiver operator characteristic curve (AUC) for the diagnosis of sentinel lymph node metastasis by intraoperative frozen section and imprint cytology was 0.854 and 0.755, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of imprint cytology were 52.1 ％ (25/48), 99.1 ％ (105/106), 96.2 ％ (25/26), 82.0 ％ (105/128), 84.4 ％ (130/154) respectively, and the corresponding diameters of frozen section were 70.8 ％ (34/48), 100.0 ％ (106/106), 100.0 ％ (34/34), 88.3 ％ (106/120), 90.9 ％ (140/154) respectively. There was no statistically significant difference between the two groups (P>0.05). The frozen section result was highly consistent with paraffin pathology, with a Kappa value of 0.7698; while the Kappa value of imprint cytology was 0.5874, which was moderately consistent with paraffin pathology. ConclusionsThere is no significant difference between imprint cytology and frozen section in the intraoperative diagnosis of sentinel lymph node metastasis. The consistency between frozen section and paraffin pathology is high. After standardized operations and professional training, imprint cytology can be considered as a substitute of intraoperative sentinel lymph node diagnosis in breast cancer patients.
