Value of intraoperative imprint cytology of sentinel nodes in patients with cervical cancer

Gynecol Oncol. 2004 Jul;94(1):175-80. doi: 10.1016/j.ygyno.2004.04.015.

Abstract

Objective: The purpose of this study was to evaluate intraoperative imprint cytology (IC) for the detection of sentinel node (SN) involvement in patients with cervical cancer.

Methods: Thirty-six consecutive patients with cervical cancer underwent a laparoscopic SN procedure with intraoperative IC, followed by complete laparoscopic pelvic lymphadenectomy, with or without laparoscopic para-aortic lymphadenectomy. The SN was bisected and both cut surfaces were applied to the surface of glass slides. Permanent sections were stained with H&E and immunohistochemical methods. The IC results were compared with the final histological results.

Results: At least one SN (mean: 2 SN per patient, range: 1-5) was detected in 34 of the 36 patients. Eight patients (22.2%) had a total of 12 metastatic SNs (four macrometastatic, five micrometastatic, and three with isolated tumor cells). No false-negative results of SN biopsy were obtained. Only one metastasis was identified by IC. No false-positive findings were obtained with IC. The overall sensitivity, specificity, accuracy, and positive and negative predictive values of IC were 8.3%, 100%, 85.7%, 100%, and 85.5%, respectively.

Conclusion: These results suggest that intraoperative imprint cytology of sentinel nodes is unreliable in patients with cervical cancer.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Cytodiagnosis / methods
  • Female
  • Humans
  • Intraoperative Period
  • Laparoscopy / methods
  • Lymph Node Excision / methods
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Middle Aged
  • Sentinel Lymph Node Biopsy / methods*
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / surgery*