Objectives: Sublobar resection, such as segmentectomy or wedge resection, is an optional procedure for resectable lung cancer if the cancer size is small or the patient's condition is poor. In such cases, intraoperative lymph node exploration is necessary to avoid incomplete resection for potential N1 or N2 diseases. In order to detect intraoperative lymph node metastasis, the semi-dry dot-blotting (SDB) method was developed. The object of this study was to examine whether the SDB method provides sufficient diagnosis of lymph node metastasis in lung cancer patients.
Methods: One hundred and forty-seven lymph nodes were examined from 50 lung cancer patients who underwent surgery in the Nagasaki University Hospital. The rationale of the SDB method originates from the antigen–antibody reaction using anti-pancytokeratin as primary antibody, and the presence of cancer cells are detected with chromogen. To identify lymph node metastasis, each lymph node was examined by the SDB method during surgery as well as intraoperative and permanent pathological diagnosis.
Results: The sensitivity, specificity, and accuracy rate of the SDB method compared to permanent pathological diagnosis was 94.7%, 97.7%, and 97.2%, respectively. Intraoperative pathological diagnosis compared to permanent pathological diagnosis was 84.2%, 100%, and 98.0%, respectively. Three cases with micrometastasis could be detected by SDB method but not by intraoperative pathological diagnosis. Three lymph nodes from lobar stations showed pseudo-positive by SDB method because of the existence of alveolar epithelium.
Conclusion: The SDB method is an effective and accurate procedure to detect lymph node metastasis. It might be an alternative method for intraoperative diagnosis of lymph node metastasis without a pathologist.
Journal Article. 0 words.
Subjects: Cardiovascular Medicine ; Cardiothoracic Surgery
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