| Theme | Clinical Application of Sentinel Node Concept for Carcinoma of the Alimentary Tract | |
|---|---|---|
| Title | How to Improve the Accuracy of Intraoperative Diagnosis of Lymph Node Metastasis | |
| Publish Date | 2007/07 | |
| Author | Shigeto Ueda | Department of Surgery, National Defense Medical College |
| Author | Hitoshi Tsuda | Department of Pathology, National Defense Medical College |
| [ Summary ] | In Japan, sentinel node navigation surgery for breast cancer, the presence or absence of metastasis into the sentinel lymph nodes (SLN), is diagnosed by intraoperative histopathological diagnosis. Intraoperative histopathological diagnosis gives rise to false negative results in approximately 10 % to 40 % of truly metastasis-positive cases. It is reported that micrometastasis (>0.2mm and ≤2.0mm in diameter) is frequently detected in SLNs. Micrometastasis is relatively frequent and accompanied by metastases to non-SLNs. In order to decrease false-negative results in intraoperative histopathological diagnosis, slice sectioning into 2 mm segments is recommended. The significance of isolated tumor cells (≤0.2 mm in diameter) in SLNs is undetermined. Recently, molecular biological methods to detect metastases to SLN at the mRNA level intraoperatively have been developed and their clinical application is expected. | |