title: Availability of tissue rinse liquid-based cytology for the rapid diagnosis of sentinel lymph node metastasis and improved bilateral detection by photodynamic eye camera.
abstract: OBJECTIVE
  On sentinel lymph node navigation surgery for early invasive cervical cancers, to gain high sensitivity and specificity, the sentinel nodes should be detected bilaterally and pathological diagnosis should be sensitive to detect micrometastasis. To improve these problems, we tried tissue rinse liquid-based cytology and the photodynamic eye.
  
  
  METHODS
  From 2005 to 2013, 102 patients with Stage Ib1 uterine cervical cancer were subjected to sentinel lymph node navigation surgery with Technetium-99 m colloid and blue dye. For the recent 11 patients with whom bilateral sentinel node detection was not available, the photodynamic eye was selectively examined. The detected sentinel node was cut along the minor axis into 2 mm slices, soaked in 10 ml CytoRich red and then subjected to tissue rinse liquid-based cytology at the time of surgery.
  
  
  RESULTS
  With the accumulation of 102 Ib1 patients subjected to sentinel lymph node navigation surgery, the bilateral sentinel node detection rate was 67.7%. The photodynamic eye was examined for the recent 11 patients who did not have bilateral signals. Out of the 11, 10 patients obtained bilateral signals successfully. During the period of examining the photodynamic eye, a total of 34 patients were subjected to sentinel lymph node navigation surgery. Thus, the overall bilateral detection rate increased to 97% in this subset. Two hundred and five lymph nodes were available as sentinel nodes. The sensitivity of tissue rinse liquid-based cytology was 91.7%, and the specificity was 100%. False positivity was 0% and false negativity was 8.3%. Detection failure was observed only with one micrometastasis and one case of isolated tumor cells.
  
  
  CONCLUSIONS
  Combination of photodynamic eye detection and tissue rinse liquid-based cytology pathology can be a promising method for more rewarding sentinel node detection.
authors.affiliation: Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan hidekato@sap-cc.go.jp.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Kato
authors.affiliation: Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ohba
authors.affiliation: Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamazaki
authors.affiliation: Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan.
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Minobe
authors.affiliation: Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Sudo
authors.affiliation: Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan.
authors.forename: Yukiharu
authors.initials: Y
authors.lastname: Todo
authors.affiliation: Division of Gynecologic Oncology, Hokkaido Cancer Center, Hokkaido, Japan.
authors.forename: Kazuhira
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Clinical pathology, Hokkaido Cancer Center, Hokkaido, Japan.
authors.forename: Katsushige
authors.initials: K
authors.lastname: Yamashiro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004867:Equipment Design; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008875:Middle Aged; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: ICG; TRLBC; cervical cancer; photodynamic eye; sentinel node