Meme karsinomlarında aksiller lenf nodlarındaki metastazların özellikleri ve mikrometastazların tesbit edilmesinde seri kesitlerin etkinliği
Küçük Resim Yok
Tarih
2001
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
1988-2001 yıllan arasında Selçuk Üniversitesi Patoloji Anabilimdalı'nda 39'u İDK, 2'si Paget Hastalığı, 2'si Paget + ÎDK, 3'ü İLK ve Vi de medüller karsinom tanısı almış 47 modifiye radikal mastektomi materyalinden 777 aksiller lenf nodu retrospektif olarak incelendi. Herbir lenf nodunun eski kesitleri tekrar gözden geçirildi metastaz içerenler ayrıldı. Metastaz içermeyenlerin parafin bloklarına 20 um aralıklarla seri kesitler uygulandı. Bunlar HE ile boyandı. Rutin incelemede 777 lenf nodunun 136 (% 17.5)'sında metastaz tesbit edilmesine karşılık seri kesitler sonrasında bu 165 (% 21)'e çıkmıştır. Arada tesbit edilen % 3.5'lik fark istatistiksel olarak anlamlı bulunmuştur. Bu 47 vakadan 19'u daha önceden lenf nod negatif olarak rapor edilmiştir. Seri kesitlerden sonra bu 19 vakanın 2 (% ll)'sinde mikrometastaz tesbit edilmiştir. Bu oranın literatürlerle uyumlu olduğu görüldü. Seri kesitlerle tesbit edilen metastazların % 93 'ü mikrometastaz (<2mm) olup bunlarında % 83'ü kapsül altı sinüsler yada kapsüler lenfatikler içinde yerleşmiş izole tümör trombüsleri şeklindedir. % 14'ü parankim içinde, % 3'ü de hem parankim içinde hem de kapsül altı sinüslerinde yerleşmiştir. Tesbit edilen metastazların % 48'i 1. kesitte, % 4'ü 2. kesitte, % 7'si 3. kesitte, % 27'si 4. kesitte, % 14'ü 5. kesitte gözlenmiştir. Kesit sayısı arttıkça metastaz sayısı azalmaktadır bu sonuç literatürle uyumlu değildir. Bu çalışmada sonuç olarak seri kesit tekniğinin rutin incelemere göre metastazları tesbit etmede daha etkili olduğunu ortaya koyduk ve rutin incelemelerde 20\ım kesit aralıklarında 6 kesit yapmanın metastazları daha yüksek oranlarda tesbit edebileceği kanısına vardık.
FEATURES OF METASTASES IN AXILLARY LYMPH NODES FROM BREAST CARCINOMAS AND EFFECTIVENESS OF SERIAL SECTIONING IN DETECTION OF MICROMETASTASES Totally 777 axillary lymph nodes from 47 modified radical mastectomy materials which were diagnosed as 39 IDC (Infiltrating Ductal Carcinoma), 2 Paget Disease+ IDC, 2 Paget Disease, 3 ILC (Infiltrating Lobular Carcinoma) and 1 medullary carcinoma at department of pathology in Selçuk University faculty of medicine during 1988-2001 were examined retrospectively. Previous sections of each lymph node were reviewed and lymph nodes which were negative for metastases were selected. Paraffin blocks of these lymph nodes were step-sectioned at 20(1 intervals and were stained by hematoxylin-eosin. After "routine" pathological examination metastases had been detectioned in (17.5%) 136 of 777 lymph nodes. Whereas after serial sections were increased 165 (21%). Difference between both detection rates was statistically significant (3.5%). In "routine" pathological examination 19 of 47 cases have been reported as lymph node negative. Micrometastases were detected in two of these cases by serial sections (11%). This rate Was accorded with literature. In this study 93% of 29 metastases which detected by serial sections were composed of micrometastases which were located in 83% subcapsular sinuses or capsular lymphatics, 14% nodal parenchyma and 3% both subcapsular lymhatics and nodal parenchyma. Accorrding to sectioning levels metastases rates were determined as 48% for 1. section, 4% for 2. section, 7% for 3. section, 27% for 4. section and 14% for 5. section. 56Consequently in this study we found that serial sections in detecting micrometastases were more effective than "routine" pathological examination. In addition we believed that step-sectioning at 20um intervals can be increased detection rates of metastases in routin pathological examinations
FEATURES OF METASTASES IN AXILLARY LYMPH NODES FROM BREAST CARCINOMAS AND EFFECTIVENESS OF SERIAL SECTIONING IN DETECTION OF MICROMETASTASES Totally 777 axillary lymph nodes from 47 modified radical mastectomy materials which were diagnosed as 39 IDC (Infiltrating Ductal Carcinoma), 2 Paget Disease+ IDC, 2 Paget Disease, 3 ILC (Infiltrating Lobular Carcinoma) and 1 medullary carcinoma at department of pathology in Selçuk University faculty of medicine during 1988-2001 were examined retrospectively. Previous sections of each lymph node were reviewed and lymph nodes which were negative for metastases were selected. Paraffin blocks of these lymph nodes were step-sectioned at 20(1 intervals and were stained by hematoxylin-eosin. After "routine" pathological examination metastases had been detectioned in (17.5%) 136 of 777 lymph nodes. Whereas after serial sections were increased 165 (21%). Difference between both detection rates was statistically significant (3.5%). In "routine" pathological examination 19 of 47 cases have been reported as lymph node negative. Micrometastases were detected in two of these cases by serial sections (11%). This rate Was accorded with literature. In this study 93% of 29 metastases which detected by serial sections were composed of micrometastases which were located in 83% subcapsular sinuses or capsular lymphatics, 14% nodal parenchyma and 3% both subcapsular lymhatics and nodal parenchyma. Accorrding to sectioning levels metastases rates were determined as 48% for 1. section, 4% for 2. section, 7% for 3. section, 27% for 4. section and 14% for 5. section. 56Consequently in this study we found that serial sections in detecting micrometastases were more effective than "routine" pathological examination. In addition we believed that step-sectioning at 20um intervals can be increased detection rates of metastases in routin pathological examinations
Açıklama
Anahtar Kelimeler
Meme, karsinom, lenf nodları, Lymph nodes, breast, carcinom
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Şahinbay, Z. (2001). Meme karsinomlarında aksiller lenf nodlarındaki metastazların özellikleri ve mikrometastazların tesbit edilmesinde seri kesitlerin etkinliği. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Tıbbi Patoloji Anabilim Dalı, Konya.
