Re-fixation in a lymph node revealing solution is a powerful method for identifying lymph nodes in colorectal resection specimens.
OBJECTIVE
To verify an impact of a lymph node revealing solution (LRS) on the number of lymph nodes (LN) revealed in colorectal resection specimens.


METHODS
Fifty-nine cases of rectosigmoid carcinomas divided into two subgroups-stage pT2&3 (20 cases) and ypT2&3 (with pre-operative radiotherapy-39 cases)-were formalin fixed for 42-72 h, serially sectioned and re-fixed in LRS containing ethanol, diethyl ether, glacial acetic acid, and formalin for 24 h. The number of LNs was matched to a control group consisting of 34 cases of colorectal carcinoma, 14 pT2&3 and 20 ypT2&3 rectosigmoid carcinomas examined routinely. Results were statistically tested by Student's t-test.


RESULTS
In the study group the total number of revealed LNs was 869, range 1-48, average 14.7 per specimen, median 15. In the control group the number of LNs was 200, range 0-13, average 5.9 per specimen, median 6. The difference between the study and the control group was statistically significant (P = 0.05).


CONCLUSIONS
Using LRS leads to a significant increase in the number of revealed LNs in colorectal resection specimens and makes it possible to find more than 12 LNs in a majority of stage pT2 and pT3 adenocarcinomas.
Department of Pathology, Faculty Hospital Královské Vinohrady and Third Medical Faculty, Charles University, Prague, Czech Republic. alexandr.svec@stees.nhs.uk
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Lysy
D019342:Acetic Acid; D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D003937:Diagnosis, Differential; D000431:Ethanol; D004986:Ether; D005557:Formaldehyde; D006801:Humans; D066298:In Vitro Techniques; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016707:Tissue Fixation / Q000379:methods*
C119829:lymph node revealing solution; D004986:Ether; D005557:Formaldehyde; D000431:Ethanol; D019342:Acetic Acid