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首页> 外文期刊>Romanian Journal of Morphology and Embryology >The evaluation of the sentinel lymph nodes status in breast carcinoma using microscopic, immunohistochemical and cytomorphometric methods in order to establish new stadializations and therapeutic schemes
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The evaluation of the sentinel lymph nodes status in breast carcinoma using microscopic, immunohistochemical and cytomorphometric methods in order to establish new stadializations and therapeutic schemes

机译：使用显微镜，免疫组织化学和细胞形态计量学方法评估乳腺癌前哨淋巴结状况，以建立新的稳态和治疗方案

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The state of axillary lymph nodes represents the most important prognostic parameter in patients with breast carcinoma. The biopsy and examination of sentinel lymph nodes, the former one containing metastases originating in mammary carcinoma, allows a better stadialization of the tumor but also the avoiding of the extirpation of the axilla, associated with a series of complications and high costs of hospitalization. In establishing the tumoral prognosis, not only the diameter but also the localization of the metastasis in the lymph nodes is utterly important. The evaluation of the metastases was carried out through the serial examination of the sentinel lymph node correlated to immunohistochemical examinations with AE1/AE3. Of the 570 patients with breast carcinoma evaluated in this research, 250 had macrometastases, 93 micrometastases, only 23 had isolated tumor cells, and in the case of 204 no metastases were found. The technique of computerized cytomorphometry allowed a better evaluation of the diameter and localization of the metastases in the lymph nodes than the examination through optical microscope. The tumoral prognosis in the case of patients with macrometastases is poorer than that of patients with micrometastases. The patients in whom only the presence of isolated tumoral cells was demonstrated have a similar prognosis with those who do not have metastases. As far as the localization of micrometastases in the sentinel lymph nodes is concerned, those with a subcapsular localization are associated with a poorer prognosis than those with an intraparenchymatous localization. As well as this, the subcapsular localization of micrometastases was also associated with the diameter of the primary tumor extending between 2-5 centimeters, a high microscopic grade, the presence of lymph vascular emboli and microscopic type of the primary tumor associated with poor prognosis. On the other hand, the presence of isolated tumoral cells was associated with tumors of a small diameter lacking the presence of lymph vascular emboli and with a low microscopic grade. All these data are essential in establishing the therapeutic management of the patients with breast carcinoma; consequently, we recommend their inclusion in future stadializations of this lesion and the evaluation of tumoral prognosis.
机译：腋窝淋巴结的状态代表了乳腺癌患者最重要的预后参数。前哨淋巴结的活检和检查（前者含有起源于乳癌的转移灶）可以使肿瘤更好地稳定，还可以避免腋窝根除，从而带来一系列并发症和高昂的住院费用。在确定肿瘤的预后中，不仅直径而且转移在淋巴结中的定位都非常重要。通过与AE1 / AE3免疫组织化学检查相关的前哨淋巴结的系列检查进行转移的评估。在这项研究评估的570例乳腺癌患者中，有250例发生了大转移，93例发生了微转移，只有23例分离出肿瘤细胞，在204例中未发现转移。与通过光学显微镜检查相比，计算机细胞形态测定技术可以更好地评估淋巴结转移的直径和位置。具有宏观转移的患者的肿瘤预后比具有微小转移的患者的肿瘤预后差。仅证实存在分离的肿瘤细胞的患者与没有转移的患者预后相似。就微转移在前哨淋巴结中的定位而言，与囊内定位相比，那些在囊下定位的患者预后较差。不仅如此，微转移的囊下定位还与原发肿瘤的直径在2-5厘米之间延伸，较高的镜检等级，淋巴血管栓塞的存在以及原发肿瘤的镜检类型相关，与预后不良相关。另一方面，分离的肿瘤细胞的存在与小直径的肿瘤相关，而该肿瘤缺乏淋巴管栓塞的存在并且显微镜等级低。所有这些数据对于建立乳腺癌患者的治疗管理至关重要。因此，我们建议将它们包括在该病灶的未来稳定状态中并评估肿瘤的预后。

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