title: Evaluation of immunohistochemical fine sectioning for sentinel lymph node biopsy in oral squamous cell carcinoma.
abstract: OBJECTIVE
  To determine the level of sentinel lymph node sectioning necessary to accurately detect nodal micrometastasis.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Tertiary care university medical center.
  
  
  METHODS
  Fine sections of oral squamous cell carcinoma sentinel lymph nodes previously sectioned at 2-mm intervals in a prospective clinical trial were reexamined. The results yielded from prior hematoxylin and eosin and immunohistochemical staining were compared with results following exhaustive serial sectioning at 150-µm intervals using identical staining methods. These experimental findings were compared with pathologic results of immediate completion selective neck dissection, previously recorded prospectively.
  
  
  RESULTS
  Reexamination of 35 sentinel nodes at 150-µm intervals has not revealed any missed micrometastatic disease at 2-mm intervals used initially. Both comparisons of 150-µm sectioning analysis to the original 2-mm section samples and to the neck dissection pathology reports demonstrate a 100% negative predictive value.
  
  
  CONCLUSIONS
  These data suggest that sentinel lymph node sectioning at 2-mm intervals for oral carcinoma using hematoxylin and eosin staining and then immunohistochemical analysis maximizes efficiency, accuracy, and expenditure for the detection of micrometastasis.
authors.affiliation: Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, USA.
authors.forename: Gina D
authors.initials: GD
authors.lastname: Jefferson
authors.forename: David
authors.initials: D
authors.lastname: Sollaccio
authors.forename: Carmen R
authors.initials: CR
authors.lastname: Gomez-Fernandez
authors.forename: Francisco
authors.initials: F
authors.lastname: Civantos
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism* / Q000556:secondary; D005240:Feasibility Studies; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D009062:Mouth Neoplasms / Q000378:metabolism* / Q000473:pathology; D037981:Neck Dissection; D009367:Neoplasm Staging; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*