title: Clinical feasibility and diagnostic accuracy of detecting micrometastatic lymph node disease in sentinel and non-sentinel lyph nodes in cervical cancer: outcomes and implications.
abstract: BACKGROUND
  Lymph node (LN) micrometastatic disease has come to prominence since ultrastaging was shown to improve the quality of LN procedures in epithelial cancers. The aim of the study was to evaluate the feasibility and diagnostic usefulness of detecting micrometastases in sentinel (SLN) and non-sentinel LNs (nSLN) in cervical cancer
  
  
  METHODS
  Twelve consecutive patients with cervical cancer stages IA to IIA, classified according to the Union for International Cancer Control (UICC) and divided into two groups: A (7) and B (5), with and without SLN procedure with methylene blue dye, who underwent radical hysterectomy and lymph nodes removal, were recruited for the study. All LNs were evaluated in hematoxylin-eosin (HE) staining and immunohistochemically (IHC) in ultrastaging with anti-cytokeratin AE1/AE3 antibodies. A detailed analysis was performed with regard to the technical and histopathological aspects of the procedure.
  
  
  RESULTS
  More LNs could be extracted and studied in group A as compared to group B (210 vs. 70, mean 30 vs. 14, respectively p < 0.0005). A total of 13 SLNs were extracted, and the identification rate was 71% (5/7 in group A). One micrometastatic LN was found in each of the groups (16% cases), but the preliminary classification of the advancement stage was changed only in 1 case from the labeled nodes group (group A--from pN0 with HE to pN1 with IHC).
  
  
  CONCLUSIONS
  Presence or absence of metastases in SLN(s) should not be sufficient amount of information for a surgeon or an oncologist, who ought to have data about all of the removed lymph nodes (sent to ultrastaging). In order for the surgery to be performed properly it is vital to ensure that SLNs were removed. Assessment of the N status ought to be taken into consideration in the classification according to the International Federation of Gynecology and Obstetrics (FIGO).
authors: Medical University of Gdansk, Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Gdansk, Poland. marcinsniadecki@gumed.edu.pl
authors: Marcin
authors: M
authors: Sniadecki
authors: Medical University of Gdansk, Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Gdansk, Poland.
authors: Sambor
authors: S
authors: Sawicki
authors: Medical University of Gdansk, Department of Pathology, Gdansk, Poland.
authors: Szymon
authors: S
authors: Wojtylak
authors: Medical University of Gdansk, Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Gdansk, Poland.
authors: Marcin
authors: M
authors: Liro
authors: Medical University of Gdansk, Department of Gynecology, Gynecologic Oncology and Gynecologic Endocrinology, Gdansk, Poland.
authors: Dariusz
authors: D
authors: Wydra
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008751:Methylene Blue; D008875:Middle Aged; D061206:Neoplasm Micrometastasis / Q000000981:diagnostic imaging / Q000473:pathology*; D009367:Neoplasm Staging; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery
chemical_list: D008751:Methylene Blue