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Diagnostic criteria of sentinel lymph node micrometastasis or macrometastasis based on tissue rinse liquid-based cytology in gynecological cancer

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International Journal of Clinical Oncology Aims and scope Submit manuscript

Abstract

Objective

This study aimed to establish intraoperative diagnostic criteria of sentinel lymph node (SLN) micro-/macrometastasis on the basis of tissue rinse liquid-based cytology (TRLBC) in gynecological cancer.

Methods

We enrolled 214 patients with gynecological cancer who underwent rapid diagnosis of SLN metastasis on the basis of TRLBC from a total of 490 SLNs. For slides that were classified as positive for atypical cells on cytological inspection, we counted the number of clusters (an atypical cell mass consisted of three or more cells) and the number of single cells (an atypical cell other than clusters). Receiver operating characteristic (ROC) analysis was applied to determine the efficiency of predicting SLN micro-/macrometastasis.

Results

On cytological inspection, 36 slides were classified as positive for atypical cells, while 21 slides (4.3%) were true positive, 15 (3.1%) were false positive, and 454 (92.6%) were true negative. There were no false negative results in this study. The area under the ROC curve for the number of cluster was superior to that for the number of single cells for distinguishing micro-/macrometastasis from negative/isolated tumor cells (0.86 vs. 0.67, P = 0.032). The optimum cut-off value of the number of clusters was 5 for distinguishing these two categories.

Conclusions

TRLBC is a highly sensitive alternative for detecting SLN metastasis as a rapid intraoperative diagnosis. Counting the number of atypical cell clusters might be useful for distinguishing micro-/macrometastasis from isolated tumor cells.

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Acknowledgements

We thank Ellen Knapp, PhD, from Edanz Group (https://en-author-services.edanzgroup.com/ac) for editing a draft of this manuscript.

Funding

This study was supported by Grants-in-Aid for Scientific Research (C) from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

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Authors and Affiliations

  1. Division of Gynecologic Oncology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo, 003-0804, Japan

    Hiroko Matsumiya, Yukiharu Todo, Ryutaro Yamada, Kaoru Minowa, Tomohiko Tsuruta, Hiroyuki Kurosu, Shinichiro Minobe & Hidenori Kato

  2. Department of Obstetrics and Gynaecology, Hokkaido University School of Medicine, Kita-14, Nishi-5, Kita-Ku, Sapporo, 060-8648, Japan

    Hiroyuki Yamazaki

  3. Division of Pathology, National Hospital Organization, Hokkaido Cancer Center, 4-2 Kikusui, Shiroishi-ku, Sapporo, 003-0804, Japan

    Hiroaki Suzuki, Kiyomi Taira & Katsushige Yamashiro

Authors
  1. Hiroko Matsumiya
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  2. Yukiharu Todo
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  3. Hiroyuki Yamazaki
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  4. Ryutaro Yamada
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  5. Kaoru Minowa
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  6. Tomohiko Tsuruta
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  7. Hiroyuki Kurosu
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  8. Shinichiro Minobe
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  9. Hidenori Kato
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  10. Hiroaki Suzuki
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  11. Kiyomi Taira
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  12. Katsushige Yamashiro
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Contributions

This study was designed, directed and coordinated by YT and KY, as the principal investigator, provided conceptual and technical guidance for all aspects of the project. HM mainly drafted the manuscript. HY performed the statistical analysis. CS, SM, RY, KM, TT, HK, and ST contributed to performing sentinel lymph node mapping surgery and collecting data information. HS, KT contributed to preparing TRLBC/paraffin block specimens and performing microscopic examination of cytological/histological specimens. KY and YT contributed equally to participating in the study design and coordination. The manuscript was written by HM and YT and commented on by all authors.

Corresponding author

Correspondence to Yukiharu Todo.

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Conflict of interest

The authors have no conflict of interest to report regarding the research content, conclusions, and significance of this study.

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Matsumiya, H., Todo, Y., Yamazaki, H. et al. Diagnostic criteria of sentinel lymph node micrometastasis or macrometastasis based on tissue rinse liquid-based cytology in gynecological cancer. Int J Clin Oncol 25, 2138–2143 (2020). https://doi.org/10.1007/s10147-020-01774-y

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  • DOI: https://doi.org/10.1007/s10147-020-01774-y

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