Evaluation of the sentinel node biopsy in colorectal carcinoma including the results of immunohistochemical examinations.
OBJECTIVE
To evaluate the method and results of sentinel node biopsy including immunohistochemical examinations in resectable colorectal cancer.


METHODS
From April 2004 to April 2005, sentinel node biopsy was carried out with the dye method in 27 patients operated on for colorectal cancer. The standard examination of sentinel nodes consisted in the evaluation of individual H&E-dyed specimens from bisection of the node. The negative sentinel nodes were examined with the use of immunohistochemistry against cytokeratins AE1/AE3.


RESULTS
The sentinel node was identified in 25 patients (92.6%). In a routine histopathological examination it included metastases in 3 cases. The sentinel node was clean in one patient whereas other regional nodes resected "en bloc" with the tumour included metastases. The sensitivity of the method was 75%, and the number of falsely negative results was 25%. Metastases (micrometastases) in the sentinel node were found in 2 other patients (8%) in the immunohistochemical examination. This examination did not change the results of the analysis in the patient with positive non-sentinel nodes and with the negative sentinel node in H&E dyeing. Nevertheless, the sensitivity of the method rose to 83.3% and the number of falsely negative results dropped to 16.7%.


CONCLUSIONS
1. The sentinel node biopsy using the dye method is a safe and relatively easy technique showing a high success rate (92.6%). 2. Low sensitivity of the method, as reflected in the literature, may result from lack of extended histopathological examinations performed on the sentinel node (e.g. immunohistochemistry). 3. Further research is necessary to determine the role and importance of the sentinel node biopsy in colorectal cancer.
Murawa
D
D
1st Clinic of Surgical Oncology, Poznań University of Medical Sciences, Poznań, Poland. dmurawa@op.pl
Filas
V
V
Breborowicz
J
J
Spychała
A
A
Dworzecka
K
K
Murawa
P
P
D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D004396:Coloring Agents; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008875:Middle Aged; D012394:Rosaniline Dyes; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
D004396:Coloring Agents; D012394:Rosaniline Dyes; C008769:sulfan blue