Feasibility of RICC in the inoperative axillary sentinel lymph node cytological smear examination for breast cancer
Objective To explore the feasibility and effect of rapid immunocytochemical technique(RICC)on axillary senti-nel lymph node(SLN)touch imprint cytology(TIC)examination in breast cancer operation.Methods From February 1,2022 to June 1,2023,100 patients who underwent modified radical mastectomy and underwent SLN biopsy in Fangcheng County People's Hospital were collected.All SLN biopsy samples were examined by TIC and RICC,and the RICC detec-tion was marked by pan-CK19.The metastatic results of breast cancer axillary SLN were based on the histological exami-nation results of paraffin sections after operation.The independent samples t-test of independent samples was used to com-pare the time required for diagnosis of TIC alone and TIC combined with RICC.According to the gold standard,the four-table x2 test was used to analyze the value of TIC examination,RICC examination and TIC combined with RICC examina-tion in diagnosing breast cancer axillary SLN metastasis,and the sensitivity,specificity positive predictive value,and nega-tive predictive value were used to analyze the diagnostic efficiency.Results The diagnostic time of TIC alone was(9.14±1.18)min,and that of TIC combined with RICC was(13.96±1.23)min,which was longer than that of TIC alone(t=28.278,P＜0.001).There were 18 positive cases detected by TIC alone,including 16 true positive cases and 2 false posi-tive cases.Eighty-two cases were negative,including 71 true negative cases and 11 false negative cases;A total of 28 cases were detected by RICC and TIC,including 25 true positive cases and 3 false positive cases;72 cases were negative,70 cases were true negative and 2 cases were false negative.The specificity and positive predictive value of TIC alone were 97.26％and 88.89％,and that of TIC combined with RICC was 95.89％and 89.29％,respectively,with no statistical significance(x2=0.207,P=0.649;x2=0.002,P=0.966),the sensitivity,accuracy and negative predictive value of the combined de-tection of TIC and RICC were 92.59％,95.00％and 97.22％,which were significantly higher than those of the single de-tection of TIC(59.26％,87.00％and 86.59％),and the difference was statistically significant(x2=8.206,P=0.004;x2=3.907,P=0.048;x2=5.612,P=0.018).Conclusion The application of RICC in TIC examination of axillary SLN in breast cancer can significantly improve its sensitivity,accuracy,negative predictive value and other diagnostic efficacy inde-xes,and the time for intraoperative diagnosis is also short,so it is feasible.
breast cancersentinel lymph nodescytological imprintrapid immunocytochemistry technology
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