No abstract available.
Endometrial Neoplasms/*pathology ; Female ; Humans ; Lymph Node Excision/*methods ; *Sentinel Lymph Node Biopsy

No abstract available.
Endometrial Neoplasms/*pathology ; Female ; Humans ; Lymph Node Excision/*methods ; *Sentinel Lymph Node Biopsy

Sentinel lymph nodes (SLNs) are the first station of lymph nodes that extend from the breast tumor to the axillary lymphatic drainage. The pathological status of these LNs can predict that of the entire axillary lymph node. Therefore, the accurate identification of SLNs is necessary for sentinel lymph node biopsy (SLNB) to replace axillary lymph node dissection (ALND). The quality of life and prognosis of breast cancer patients are related to proper surgical treatment after the precise identification of SLNs. Some of the SLN tracers that have been identified include radioisotope, nano-carbon, indocyanine green (ICG), and methylene blue (MB). However, these tracers have certain limitations, such as pigmentation, radiation dangers, and the requirement for costly detection equipment. Ultrasound contrast agents (UCAs) have good specificity and sensitivity, and thus can compensate for some shortcomings of the mentioned tracers. This technique is also being applied to SLNB in patients with breast cancer, and can even provide an initial judgment on SLN status. Contrast-enhanced ultrasound (CEUS) has the advantages of high distinguishability, simple operation, no radiation harm, low cost, and accurate localization; therefore, it is expected to replace the traditional biopsy methods. In addition, it can significantly enhance the accuracy of SLN localization and shorten the operation time.
Humans ; Female ; Sentinel Lymph Node/pathology* ; Breast Neoplasms/pathology* ; Quality of Life ; Sentinel Lymph Node Biopsy/methods* ; Ultrasonography/methods* ; Lymph Nodes/surgery*

As a minimally invasive method, sentinel lymph node biopsy (SLNB) in conjunction with guidance methods is the standard method to determine cancer metastasis in breast. The desired guidance methods for SLNB should be capable of precise SLN localization for accurate diagnosis of micro-metastases at an early stage of cancer progression and thus facilitate reducing the number of SLN biopsies for minimal surgical complications. For this, high sensitivity to the administered dyes, high spatial and contrast resolutions, deep imaging depth, and real-time imaging capability are pivotal requirements. Currently, various methods have been used for SLNB guidance, each with their own advantages and disadvantages, but no methods meet the requirements. In this review, we discuss the conventional SLNB guidance methods in this perspective. In addition, we focus on the role of the PA imaging modality on real-time SLN identification and biopsy guidance. In particular, PA-based hybrid imaging methods for precise SLN identification and efficient biopsy guidance are introduced, and their unique features, advantages, and disadvantages are discussed.
Biopsy* ; Breast ; Coloring Agents ; Contrast Media ; Diagnosis ; Lymph Nodes* ; Methods ; Neoplasm Metastasis ; Optical Imaging ; Sentinel Lymph Node Biopsy ; Ultrasonography

OBJECTIVETo detect the sentinel lymph nodes (SLN) of rabbit thyroid by fluorescence imaging and to provide experimental evidence for its clinical application.

METHODSEqual concentration and dose (35 nmol/L, 1 ml) of ICG (indocyanine green) or ICG:CSA (calf serum albumin) complex was injected into rabbit thyroid to measure the their fluorescence amount. Twenty rabbits were randomly divided into ICG group and ICG:CSA group, with 10 rabbits each group, rabbit thyroid was separately injected with 0.02 ml of 100 nmol/L ICG and 0.02 ml of methylene, or 0.02 ml of 35 nmol/L ICG:CSA and 0.02 ml of methylene, and then ICG fluorescence and methylene staining in SLN were detected respectively.

RESULTSFluorescence amount of ICG:CAS was three times that of ICG with the same concentration and dose. SLNs were showed in all rabbits injected with ICG or ICG:CSA, but found only in 16 of 20 rabbits injected with methylene blue. The accuracy of fluorescence imaging and blue dye imaging were respectively 95.8% and 79.2%.

CONCLUSIONFluorescence imaging, using ICG or ICG:CSA as a tracer, could be an alternative method for the detection of SLN of thyroid in future clinical practice.

Animals ; Fluorescence ; Indocyanine Green ; Lymph Nodes ; Optical Imaging ; methods ; Rabbits ; Sentinel Lymph Node Biopsy ; methods ; Thyroid Gland

OBJECTIVETo detect the lymph nodes (LN) of rabbit thyroid by fluorescence imaging and to provide experimental evidence for its clinical application.

METHODSEach of 50 lateral thyroid lobes of 25 rabbits was injected with 0.02 ml of indocyanine green (ICG), and 0.02 ml methylene followed. ICG fluorescence was detected using photodynamic eye (PDE). The methylene staining in LN was also observed. The onset time of ICG staining in LN was measured.

RESULTSThe detection rate of fluorescence imaging and blue dye imaging were respectively 86.0% (43/50) and 66.0% (33/50), with a significant difference (P = 0.034), and the accuracy were respectively 85.5% (53/62) and 70.7% (41/58). The onset time (x(-) ± s) of ICG staining in LN was (118.3 ± 16.1) s.

CONCLUSIONSFluorescence imaging showed satisfied detection rate and accuracy. The detection rate of LN by fluorescence imaging was higher than that by blue dye imaging. Fluorescence imaging could be an alternative method for the detection of LN of thyroid in future clinical practice.

Animals ; Drainage ; methods ; Fluorescence ; Indocyanine Green ; Lymph Nodes ; cytology ; Optical Imaging ; Rabbits ; Sentinel Lymph Node Biopsy ; methods ; Thyroid Gland

PURPOSE: Axillary lymph node dissection (ALND) may be avoidable for breast cancer patients with 1-2 positive lymph nodes (LN) after breast-conserving therapy. However, the effects of ALND after mastectomy remain unclear because radiation is not routinely used. Herein, we compared the benefits of post-mastectomy ALND versus sentinel node biopsy (SNB) alone for breast cancer patients with 1-3 metastatic LNs. MATERIALS AND METHODS: A total of 1,697 patients with pN1 disease who underwent mastectomy during 2000-2015 were identified from an institutional database. Outcomes were compared using the inverse probability of treatment weighted method. RESULTS: Patients who underwent SNB tended to have smaller tumors, a lower histology grade, a lower number of positive LNs, and better immunohistochemical findings. After correcting all confounding factors regarding patient, tumor, and adjuvant treatment, the SNB and ALND groups did not differ in terms of overall survival (OS) and disease-free survival (DFS), distant metastasis and locoregional recurrence. The 10-year DFS and OS rates were 83% and 84%, respectively, during a median follow-up period of 93 months. CONCLUSION: ALND did not improve post-mastectomy survival outcomes among patients with N1 breast cancer, even after adjusting for all histopathologic and treatment-related factors.
Biopsy ; Breast Neoplasms ; Breast ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Mastectomy ; Methods ; Neoplasm Metastasis ; Recurrence ; Sentinel Lymph Node Biopsy

Cervical cancer is the most common gynecological malignant carcinoma in Chinese women, which seriously threatens women's health. Lymph node metastasis is the most important factor affecting the prognosis and adjuvant treatment of patients with early cervical cancer. Conventional systematic lymphadenectomy has always been a reliable method to detect lymph node metastasis. However, this procedure may affect the quality of life of patients because of high risks of complications. Recently, sentinel lymph node biopsy (SLNB) has been researched aiming to assess the status of pelvic lymph node metastasis intraoperatively, avoid unnecessary lymphadenectomy and achieve the goal of individualized diagnosis and treatment. Exploring efficient tracing methods and pathological ultra-staging is the key to the clinical application of SLNB for cervical cancer, and understanding the latest relevant clinical research progress will help SLNB to be applied in the clinic as soon as possible to benefit patients with cervical cancer.
Female ; Humans ; Lymph Node Excision/methods* ; Lymph Nodes/surgery* ; Lymphatic Metastasis/pathology* ; Neoplasm Staging ; Quality of Life ; Sentinel Lymph Node/surgery* ; Sentinel Lymph Node Biopsy/methods* ; Uterine Cervical Neoplasms/surgery*

BACKGROUNDAccurate intraoperative diagnosis of sentinel lymph node (SLN) metastases enables the selection of patients for axillary lymph node dissections during the same operation, reducing the need for a second operation. The present study aimed to prospectively compare the GeneSearch(TM) Breast Lymph Node (BLN) Assay with touch imprint cytology (TIC) for intraoperative evaluation of SLNs.

METHODSSLNs were sectioned in 1.5 - 3.0 mm pieces. TIC was performed on all pieces and the BLN Assay and postoperative histology evaluations were performed on different alternating node pieces. Overall performance of the BLN Assay was compared with that of TIC relative to the postoperative histology results.

RESULTSA total of 90 patients enrolled in the study. Complete intraoperative data for both the BLN Assay and TIC were collected in 86 patients. The sensitivity, specificity, and overall accuracy of the BLN Assay were 82%, 97%, and 92%, respectively on a per patient basis compared with those of TIC which were 67%, 100%, and 90%.

CONCLUSIONSPerformance of the BLN Assay was superior to that of TIC and the additional application of TIC did not help improve the total sensitivity and accuracy of the intraoperative assessment. The existence of ectopic breast tissue might be a possible cause of false positive for the BLN assay. In addition, the BLN Assay complements histopathology assessment and can minimize sampling error without increasing pathologists' workload.

Adult ; Aged ; Cytodiagnosis ; methods ; Female ; Humans ; Intraoperative Period ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Sentinel Lymph Node Biopsy ; methods

Axilla ; Breast Neoplasms ; pathology ; surgery ; Cytodiagnosis ; methods ; Female ; Humans ; Immunohistochemistry ; Lymph Node Excision ; Lymph Nodes ; pathology ; Neoplasm Metastasis ; Sentinel Lymph Node Biopsy ; methods