Intraoperative evaluation of axillary sentinel lymph nodes using touch imprint cytology and immunohistochemistry: I. Protocol of rapid immunostaining of touch imprints.
OBJECTIVE
Sentinel Node Biopsy (SNB) is considered an accurate method of detecting axillary lymph node status in patients with small breast cancer. Combined with an accurate and rapid histopathology tool, it could spare this group of patients unnecessary Axillary Node Clearance (ANC) with its associated hazards. Intraoperative examination of SNB for cancer cells has been investigated using both Frozen Sections (FS) and Imprint Cytology (IC) stained with different stains. This study is devoted to establish a reliable and rapid protocol for immunostaining of touch imprints from SNB.


METHODS
We investigated two different EPOS (Enhanced Polymer One-Step staining--DAKO) anticytokeratin antibodies, five different tissue fixatives and different incubation periods and temperatures with both positive and negative controls.


RESULTS
We have developed a protocol, which produced good and consistent immunostaining of touch imprints. The initial results using this protocol are concordant with those of permanent Haematoxylin and Eosin (H&E) sections.


CONCLUSIONS
We propose this protocol for rapid immunostaining of touch imprints of SNB.
Salem
A A
AA
Department of Surgery, University of Wales College of Medicine, Heath Park, Cardiff CF14 4XN, Wales, UK. salemaa1@cf.ac.uk
Douglas-Jones
A G
AG
Sweetland
H M
HM
Mansel
R E
RE
D000906:Antibodies; D001365:Axilla / Q000473:pathology* / Q000601:surgery*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000601:surgery; D002277:Carcinoma / Q000175:diagnosis / Q000601:surgery; D000431:Ethanol / Q000494:pharmacology; D005260:Female; D005404:Fixatives / Q000494:pharmacology; D016591:Histocytological Preparation Techniques / Q000592:standards; D006801:Humans; D007150:Immunohistochemistry / Q000592:standards; D007430:Intraoperative Care / Q000592:standards; D007633:Keratins; D008198:Lymph Nodes / Q000166:cytology / Q000473:pathology* / Q000601:surgery*; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy / Q000592:standards; D012997:Solvents / Q000494:pharmacology; D013696:Temperature; D013997:Time Factors
D000906:Antibodies; D005404:Fixatives; D012997:Solvents; D000431:Ethanol; D007633:Keratins