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Rapid diagnosis of lymph node metastasis in breast cancer using a new fluorescent method with ?-glutamyl hydroxymethyl rhodamine green.

ABSTRACT: Sentinel lymph node biopsy is performed as a standard procedure in breast cancer surgery, and the development of quick and simple methods to detect metastatic lesions is in high demand. Here, we validated a new fluorescent method using ?-glutamyl hydroxymethyl rhodamine green to diagnose metastatic lymph nodes in breast cancer. One hundred and forty-nine lymph nodes from 38 breast cancer patients were evaluated in this study. Comparison of fluorescent and pathological images showed that this fluorescent method was successful for visualizing breast cancer cells in lymph nodes. This method had a sufficiently high sensitivity (97%), specificity (79%) and negative predictive value (99%) to render it useful for an intraoperative diagnosis of cancer. These preliminary findings suggest that this novel method is useful for distinguishing non-cancerous specimens from those in need of careful examination and could help save time and cost for surgeons and pathologists.

SUBMITTER: Shinden Y

PROVIDER: S-EPMC4899706 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Rapid diagnosis of lymph node metastasis in breast cancer using a new fluorescent method with γ-glutamyl hydroxymethyl rhodamine green.

Shinden Yoshiaki Y Ueo Hiroki H Tobo Taro T Gamachi Ayako A Utou Mitsuaki M Komatsu Hisateru H Nambara Sho S Saito Tomoko T Ueda Masami M Hirata Hidenari H Sakimura Shotaro S Takano Yuki Y Uchi Ryutaro R Kurashige Junji J Akiyoshi Sayuri S Iguchi Tomohiro T Eguchi Hidetoshi H Sugimachi Keishi K Kubota Yoko Y Kai Yuichiro Y Shibuta Kenji K Kijima Yuko Y Yoshinaka Heiji H Natsugoe Shoji S Mori Masaki M Maehara Yoshihiko Y Sakabe Masayo M Kamiya Mako M Kakareka John W JW Pohida Thomas J TJ Choyke Peter L PL Kobayashi Hisataka H Ueo Hiroaki H Urano Yasuteru Y Mimori Koshi K

Scientific reports 20160609

Sentinel lymph node biopsy is performed as a standard procedure in breast cancer surgery, and the development of quick and simple methods to detect metastatic lesions is in high demand. Here, we validated a new fluorescent method using γ-glutamyl hydroxymethyl rhodamine green to diagnose metastatic lymph nodes in breast cancer. One hundred and forty-nine lymph nodes from 38 breast cancer patients were evaluated in this study. Comparison of fluorescent and pathological images showed that this flu ...[more]

PMID: 27277343

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Project description:BackgroundAlthough lobectomy is considered the standard surgery for any non-small cell lung cancer (NSCLC), recent evidence indicates that for early NSCLCs segmentectomy may be equally effective. For segmentectomy to be oncologically safe, however, adequate intraoperative lymph node staging is essential. The aim of this study was to compare the results of a new rapid-IHC system to the HE analysis for intraoperative nodal diagnosis in lung cancer patients considered for segmentectomy.MethodsThis retrospective study analyzed the pathological reports from NSCLC resections over a six-year period between 2014 and 2020. Using a new device for rapid-IHC, we applied a high-voltage, low-frequency alternating current (AC) field, which mixes the antipancytokeratin antibody as the voltage is switched on/off. Rapid-IHC can provide a nodal diagnosis within 20 minutes.ResultsFrozen sections from 106 resected lymph nodes from 70 patients were intraoperatively evaluated for metastasis. Of those, five nodes were deemed positive based on both HE staining and rapid-IHC. In addition, rapid-IHC alone detected isolated tumor cells in one hilar lymph node. Three cStage IA patients with nodal metastasis detected with HE staining and rapid-IHC received complete lobectomies. Five-year relapse-free survival and overall survival among patients receiving segmentectomy with rapid-IHC were 88.77% and 88.79%, respectively.ConclusionsRapid-IHC driven by AC mixing is simple, highly accurate, and preserves nodal tissue for subsequent tests. This system can be used effectively for intraoperative nodal diagnosis. Rapid immunohistochemistry based on alternating-current field mixing (completed within 20 minutes) is simple and highly accurate. This system will assist clinicians when making intraoperative diagnoses of lymph node metastasis and deciding upon the appropriate surgical procedure in segmentectomy for lung cancer.Key pointsSIGNIFICANT FINDINGS OF THE STUDY: Rapid immunohistochemistry driven by alternating-current field mixing (completed within 20 minutes intraoperatively) is simple, highly accurate, and preserves lymph node tissue for subsequent pathological examination, including molecular assessments.What this study addsSegmentectomy for lung cancer is oncologically safe, but only when there is adequate intraoperative node staging. Rapid immunohistochemistry will assist clinicians when making intraoperative nodal diagnoses.

Dataset Information

Rapid diagnosis of lymph node metastasis in breast cancer using a new fluorescent method with ?-glutamyl hydroxymethyl rhodamine green.

Publications

Rapid diagnosis of lymph node metastasis in breast cancer using a new fluorescent method with γ-glutamyl hydroxymethyl rhodamine green.

Similar Datasets

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