Evaluation of immunohistochemical fine sectioning for sentinel lymph node biopsy in oral squamous cell carcinoma

• Published in: Otolaryngology-head and neck surgery Vol. 144; no. 2; p. 216
• Main Authors: Jefferson, Gina D, Sollaccio, David, Gomez-Fernandez, Carmen R, Civantos, Jr, Francisco
• Format: Journal Article
• Language: English
• Published: England 01.02.2011
• Subjects: Carcinoma, Squamous Cell - diagnosis; Carcinoma, Squamous Cell - metabolism; Carcinoma, Squamous Cell - secondary; Feasibility Studies; Humans; Immunohistochemistry - methods; Lymph Nodes - pathology; Lymph Nodes - surgery; Lymphatic Metastasis; Mouth Neoplasms - metabolism; Mouth Neoplasms - pathology; Neck Dissection; Neoplasm Staging; Retrospective Studies; Sentinel Lymph Node Biopsy - methods
• ISSN: 1097-6817
• DOI: 10.1177/0194599810391199

To determine the level of sentinel lymph node sectioning necessary to accurately detect nodal micrometastasis. Cross-sectional. Tertiary care university medical center. Fine sections of oral squamous cell carcinoma sentinel lymph nodes previously sectioned at 2-mm intervals in a prospective clinical trial were reexamined. The results yielded from prior hematoxylin and eosin and immunohistochemical staining were compared with results following exhaustive serial sectioning at 150-µm intervals using identical staining methods. These experimental findings were compared with pathologic results of immediate completion selective neck dissection, previously recorded prospectively. Reexamination of 35 sentinel nodes at 150-µm intervals has not revealed any missed micrometastatic disease at 2-mm intervals used initially. Both comparisons of 150-µm sectioning analysis to the original 2-mm section samples and to the neck dissection pathology reports demonstrate a 100% negative predictive value. These data suggest that sentinel lymph node sectioning at 2-mm intervals for oral carcinoma using hematoxylin and eosin staining and then immunohistochemical analysis maximizes efficiency, accuracy, and expenditure for the detection of micrometastasis.