Ultrastaging of Sentinel Lymph Nodes in Endometrial Carcinoma According to Use of 2 Different Methods

被引:40
|
作者
Euscher, Elizabeth [1 ]
Sui, Dawen [2 ]
Soliman, Pamela [3 ]
Westin, Shannon [3 ]
Ramalingam, Preetha [1 ]
Bassett, Roland [2 ]
Malpica, Anais [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Pathol, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Gynecol Oncol & Reprod Med, Houston, TX 77030 USA
关键词
Endometrial cancer; Sentinel lymph node; Metastasis; Ultrastaging; CANCER; METASTASIS; BIOPSY; RISK; INJECTION; ACCURACY; PATTERNS;
D O I
10.1097/PGP.0000000000000415
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Sentinel lymph node (SLN) sampling may provide staging information without exposing patients to risks of lymph node dissection. There is no consensus protocol for optimal pathologic handling of these specimens. This study compares 2 ultrastaging protocols of SLN in endometrial carcinoma (EC). All SLN were serially sectioned perpendicular to the long axis in 2 mm intervals and entirely submitted for routine hematoxylin and eosin (H&E) processing. SLN negative by routine processing had ultrastaging (US) by one of the following: method 1 (M1), 5 H&E levels at 250 m intervals with 2 unstained slides at each level; pankeratin immunohistochemistry (IHC) performed on level 1 in cases with negative H&E levels or method 2 (M2), 1 H&E level + 2 unstained slides cut 250 m into the tissue block; pankeratin IHC performed in cases with negative H&E. Histologic subtype, numbers of SLN, positive SLN, non-SLN, positive non-SLN, and metastasis size were recorded. A total of 178 patients had 527 SLNs (1-16 per case; median, 2 SLN) sampled during hysterectomy for the following EC histotypes: endometrioid International Federation of Gynecology and Obstetrics grade 1/2, 117 (66%); endometrioid International Federation of Gynecology and Obstetrics grade 3, 18 (10%); serous, 20 (11%); carcinosarcoma, 11 (6%); clear cell, 9 (5%); and undifferentiated, 3 (2%). In all, 172 patients had ultrastaging: M1=65; M2=58. In total, 33 patients were SLN positive. Twenty-seven had SLN submitted for US: M1=11; M2=16. Eleven patients had additional SLN detected by US: M1=5; M2=6. Of these, 8 were patients whose SLN were only detected by US representing an increase of 32% in number of patients with positive SLN. Six patients (M1=2; M2=4) with negative SLN had a positive non-SLN. Mean size of ultrastage-detected metastasis was 0.24 mm for M1 and 0.38 mm for M2. Statistical analysis comparing M1 and M2 detected no statistically significant associations with respect to number of positive SLN detected, size of metastasis or false-negative rate and method. The methods performed similarly for both low-grade and high-grade EC. A more comprehensive US protocol had no significant advantages over a single wide interval and IHC in this study population. A pankeratin IHC stain enhances metastasis detection. Additional studies are required to further test this limited protocol as well as to evaluate the clinical significance of the low volume disease detected by ultrastaging.
引用
收藏
页码:242 / 251
页数:10
相关论文
共 50 条
  • [1] Ultrastaging methods of sentinel lymph nodes in endometrial cancer - a systematic review
    Burg, Lara C.
    Hengeveld, Ellen M.
    't Hout, Joanna in
    Bulten, Johan
    Bult, Peter
    Zusterzeel, Petra L. M.
    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER, 2021, 31 (05) : 744 - 753
  • [2] Ultrastaging of Sentinel Lymph Nodes in Endometrial Carcinoma: A Tale of Two Protocols
    Euscher, Elizabeth
    Sui, Dawen
    Ramalingam, Preetha
    Bassett, Roland
    Malpica, Anais
    MODERN PATHOLOGY, 2015, 28 : 283A - 283A
  • [3] Nanometastases of endometrial carcinoma to sentinel lymph nodes: The contribution of pathologic ultrastaging
    Kim, C.
    Collado, F. Khoury
    Barlin, J.
    Park, K.
    Cassella, D.
    Sonoda, Y.
    Hensley, M.
    Chi, D.
    Barakat, R.
    Abu-Rustum, N.
    GYNECOLOGIC ONCOLOGY, 2012, 125 : S154 - S154
  • [4] Ultrastaging of Sentinel Lymph Nodes in Endometrial Carcinoma: A Tale of Two Protocols
    Euscher, Elizabeth
    Sui, Dawen
    Ramalingam, Preetha
    Bassett, Roland
    Malpica, Anais
    LABORATORY INVESTIGATION, 2015, 95 : 283A - 283A
  • [5] Pathologic Ultrastaging of Sentinel Lymph Nodes in Endometrial Cancer
    Khoury-Collado, F.
    Soslow, R. A.
    Murray, M. P.
    Gemignani, M. L.
    Abu Rustum, N. R.
    MODERN PATHOLOGY, 2010, 23 : 249A - 249A
  • [6] Pathologic Ultrastaging of Sentinel Lymph Nodes in Endometrial Cancer
    Khoury-Collado, F.
    Soslow, R. A.
    Murray, M. P.
    Gemignani, M. L.
    Abu Rustum, N. R.
    LABORATORY INVESTIGATION, 2010, 90 : 249A - 249A
  • [7] Implantation of Ultrastaging Methods for Endometrial Cancer Sentinel Lymph Nodes: Impacts and Recommendations
    Perrault, Florence
    Choiniere, Roselyne
    Granger, Perrine
    MODERN PATHOLOGY, 2022, 35 (SUPPL 2) : 812 - 813
  • [8] Implantation of Ultrastaging Methods for Endometrial Cancer Sentinel Lymph Nodes: Impacts and Recommendations
    Perrault, Florence
    Choiniere, Roselyne
    Granger, Perrine
    LABORATORY INVESTIGATION, 2022, 102 (SUPPL 1) : 812 - 813
  • [9] Pathologic ultrastaging of sentinel lymph nodes improves the detection of metastatic endometrial cancer
    Collado, F. Khoury
    Soslow, R.
    Pandit-Taskar, N.
    Diaz, J.
    Murray, M.
    Chi, D.
    Barakat, R.
    Gemignani, M.
    Abu-Rustum, N.
    GYNECOLOGIC ONCOLOGY, 2010, 116 (03) : S72 - S73
  • [10] Sentinel Lymph Node Ultrastaging in Endometrial Carcinoma: Compliance and Standardized Reporting
    De Villa, Vanessa Grace M.
    Chapman, William
    Clarke, Blaise
    Rouzbahman, Marjan
    Cesari, Matthew
    Vicus, Danielle
    Ferguson, Sarah
    Shaw, Patricia
    LABORATORY INVESTIGATION, 2018, 98 : 416 - 416