title: Advantages of the rapid double-staining method for intraoperative detection of micrometastasis in sentinel lymph nodes.
abstract: For rapid intraoperative diagnosis of lymph node micrometastasis, we refined the rapid immunohistochemistry method by combining anti-cytokeratin antibody-labeled nanocrystal beads with rapid hematoxylin and eosin (H&E) staining on the same section, referred to as the rapid double staining (RDS) technique. Two frozen-section slices each were obtained from 372 lymph nodes of 100 breast cancer patients. We performed RDS for 1 slide and rapid H&E staining for the other. The results were compared with the corresponding final pathological data obtained from the permanent specimens. For specimens from patients with pN1(mi) as determined by final pathological examination, the false‑negative rate was 33.3% for rapid H&E staining and 16.7% for RDS. For specimens from patients with pN0(i+) as determined by final pathological examination, the false‑negative rate was 80% for rapid H&E staining and 0% for RDS. These results indicate that RDS is superior to conventional rapid H&E staining for intraoperative diagnosis of nodal micrometastasis and isolated tumor cells.
authors.affiliation: Gastroenterologic Surgery, Department of Oncology, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Ishikawa 920-8641, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ojima
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kinami
authors.forename: Keishi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Oyama
authors.forename: Masashi
authors.initials: M
authors.lastname: Inokuchi
authors.forename: Hideto
authors.initials: H
authors.lastname: Fujita
authors.forename: Itasu
authors.initials: I
authors.lastname: Ninomiya
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Seiko
authors.initials: S
authors.lastname: Kitamura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Harada
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007430:Intraoperative Care; D007633:Keratins / Q000032:analysis; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008408:Mastectomy; D061206:Neoplasm Micrometastasis / Q000175:diagnosis*; D021701:Sentinel Lymph Node Biopsy; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D007633:Keratins