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. 2012 Jun;7(3):216-219.
doi: 10.1159/000339686. Epub 2012 Jun 22.

Clinical Implications of Micrometastasis Detection in Internal Mammary Nodes of Breast Cancer Patients

Jian Zeng  1 , Huazhi Xie, Yunfei Lu, Zhenbo Feng, Fu Li
Affiliations

Clinical Implications of Micrometastasis Detection in Internal Mammary Nodes of Breast Cancer Patients

Jian Zeng et al. Breast Care (Basel). 2012 Jun.

Abstract
in English, German

BACKGROUND: The aim of this study was to assess the efficiency of step-serial sectioning (SSS) combined with hematoxylin and eosin (H&E) and immunohistochemical (IHC) staining in detecting micrometastasis of internal mammary lymph nodes (IMLNs). PATIENTS AND METHODS: 135 IMLNs from 88 breast cancer patients were re-examined by SSS, combined with either H&E or IHC staining of the biomarkers cytokeratin-19 and epithelial membrane antigen. RESULTS: Of the 135 IMLNs, 6 nodes from 5 cases displayed 1 or more micrometastases. Histological grade and lymphovascular invasion status were significantly correlated with micrometastasis in the IMLNs (p = 0.018 and 0.001, respectively). Of the 6 nodes positive for micrometastasis, 1 node was detected by both H&E and IHC staining. The remaining 5 nodes from 4 cases showed evident tumor cells only by IHC staining. Finally 8 of the 83 patients (9.64%) without IMLN metastasis showed distant metastasis, while 2 of the 5 patients (40%) with IMLN metastasis showed distant metastasis within 28 months of operation. CONCLUSION: SSS combined with H&E and IHC staining is more efficient in detecting micrometastasis than classic routine single-slice H&E only.

Hintergrund: Ziel dieser Studie war die Bestimmung der Effizienz des Step-Serial Sectioning (SSS) kombiniert mit Hämatoxylin-Eosin (H&E)-Färbung bzw. immunhistochemischer (IHC) Färbung zur Detektion von Mikrometastasen in den Mammaria-interna-Lymphknoten.

Patientinnen und Methoden: 135 Mammaria-interna-Lymphknoten von 88 Mammakarzinompatientinnen wurden mittels SSS kombiniert mit H&E- bzw. IHC-Färbung erneut auf die Biomarker Cytokeratin-19 und epitheliales Membranantigen untersucht.

Ergebnisse: Von den 135 Mammaria-interna-Lymphknoten zeigten 6 Knoten von 5 Fällen eine oder mehrere Mikrometastasen. Der histologische Grad und lymphovasku-läre Invasionsstatus waren signifikant mit dem Vorliegen von Mikrometastasen in den Mammaria-interna-Lymphknoten korreliert (p = 0,018 bzw. 0,001). Einer der 6 positiven Lymphknoten konnte sowohl mit H&E- als auch mit IHC-Färbung dargestellt werden. Für die verbleibenden 5 Knoten von 4 Fällen konnte nur die IHC-Färbung Tumorzellen nachweisen. Insgesamt zeigten 8 der 83 Patientinnen (9,64%) ohne Metastasen in den Mammaria-interna-Lymphknoten Fernmetastasen, während 2 der 5 Patientinnen (40%) mit Metastasen in den Mammaria-interna-Lymphknoten innerhalb von 28 Monaten nach Operation Fernmetastasen aufwiesen.

Schlussfolgerung: SSS kombiniert mit H&E- bzw. IHC-Färbung ist beim Aufzeigen von Mikrometastasen effektiver als die routinemäßig eingesetzte, klassische Single-Slice-H&E-Färbung.

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Figures

Fig. 1
Fig. 1
Microscopy images of micrometastases in the parenchyma (CK-19, ×400).
Fig. 2
Fig. 2
Isolated tumor cells/clusters in the subcapsular sinuses (EMA, ×400).
Fig. 3
Fig. 3
Isolated tumor cells dispersed in a diffuse pattern in infiltrating lobular carcinoma (EMA, left ×100, central ×400), but stained negatively with H&E (right).
See this image and copyright information in PMC

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