title: [Analysis of intraoperative molecular assessment of sentinel lymph nodes in breast carcinoma].
abstract: OBJECTIVE
  To evaluate the reliability and application of GeneSearch(TM) breast lymph node assay (Genesearch), a real-time fluorescence quatitative PCR method, in intraoperative assay of metastasis in sentinel lymph nodes (SLNs) from breast cancer patients.
  
  
  METHODS
  Totally 140 SLNs from 80 patients with breast carcinoma were prospectively studied from May 2010 to August 2010. The 80 patients included 78 women and 2 men who ranged in age from 29 to 85 years, and the median age is 49 years. The expression of CK19 and mammaglobulin in all 140 SLNs were detected by Genesearch, and the results were compared with that of histological evaluation of both frozen and paraffin-embedded sections.
  
  
  RESULTS
  Among SLNs, by histological analyses, there were 121 without metastasis, 17 with macrometastasis, 2 with micrometastasis, and none of isolated tumor cell. By Genesearch, there were 119 without metastasis and 21 with metastasis. Genesearch showed sensitivity of 89.4%, positive predictive value of 81.0%, negative predictive value of 98.3% and specificity of 96.7% by comparing to histological analyses. The concordance between Genesearch and histological analysis was 95.7%. The sensitivity of Genesearch was 15/17 for macrometastasis and 2/2 for micrometastasis.
  
  
  CONCLUSIONS
  Genesearch detection presents high sensitivity and specificity in evaluating metastasis of sentinel lymph nodes in breast cancer, but strict performance technically is necessary to avoid false positive and false negative results. Inability of further subtyping for the positive cases might be the key limitations for wide application of this method.
authors.affiliation: Department of Pathology, Peking University First Hospital, Beijing 100034, China.
authors.forename: Yun-hong
authors.initials: YH
authors.lastname: Wang
authors.forename: Hong
authors.initials: H
authors.lastname: Zhang
authors.forename: Xue-ning
authors.initials: XN
authors.lastname: Duan
authors.forename: Cheng-ze
authors.initials: CZ
authors.lastname: Yu
authors.forename: De-qi
authors.initials: DQ
authors.lastname: Yang
authors.forename: Bo
authors.initials: B
authors.lastname: Li
authors.forename: Ting
authors.initials: T
authors.lastname: Li
authors.forename: Yin-hua
authors.initials: YH
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018567:Breast Neoplasms, Male / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000175:diagnosis; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy