دورية أكاديمية
Sentinel Lymph Node Mapping in Lung Cancer: A Pilot Study for the Detection of Micrometastases in Stage I Non-Small Cell Lung Cancer.
| العنوان: | Sentinel Lymph Node Mapping in Lung Cancer: A Pilot Study for the Detection of Micrometastases in Stage I Non-Small Cell Lung Cancer. |
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| المؤلفون: | Romano G; Minimally Invasive and Robotic Thoracic Surgery, Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124 Pisa, Italy., Zirafa CC; Minimally Invasive and Robotic Thoracic Surgery, Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124 Pisa, Italy., Calabrò F; Minimally Invasive and Robotic Thoracic Surgery, Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124 Pisa, Italy., Alì G; Pathological Anatomy, Surgical, Medical, Molecular, and Critical Care Pathology Department, University Hospital of Pisa, 56124 Pisa, Italy., Manca G; Nuclear Medicine, Department of Translational Research and New Technology in Medicine, University of Pisa, 56124 Pisa, Italy., De Liperi A; 2nd Radiology Unit, Department of Diagnostic Imaging, University Hospital of Pisa, 56124 Pisa, Italy., Proietti A; Pathological Anatomy, Surgical, Medical, Molecular, and Critical Care Pathology Department, University Hospital of Pisa, 56124 Pisa, Italy., Manfredini B; Minimally Invasive and Robotic Thoracic Surgery, Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124 Pisa, Italy., Di Stefano I; Pathological Anatomy, Surgical, Medical, Molecular, and Critical Care Pathology Department, University Hospital of Pisa, 56124 Pisa, Italy., Marciano A; Nuclear Medicine, Department of Translational Research and New Technology in Medicine, University of Pisa, 56124 Pisa, Italy., Davini F; Minimally Invasive and Robotic Thoracic Surgery, Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124 Pisa, Italy., Volterrani D; Nuclear Medicine, Department of Translational Research and New Technology in Medicine, University of Pisa, 56124 Pisa, Italy., Melfi F; Minimally Invasive and Robotic Thoracic Surgery, Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124 Pisa, Italy. |
| المصدر: | Tomography (Ann Arbor, Mich.) [Tomography] 2024 May 15; Vol. 10 (5), pp. 761-772. Date of Electronic Publication: 2024 May 15. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: MDPI Country of Publication: Switzerland NLM ID: 101671170 Publication Model: Electronic Cited Medium: Internet ISSN: 2379-139X (Electronic) Linking ISSN: 23791381 NLM ISO Abbreviation: Tomography Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2021- : Basel, Switzerland : MDPI Original Publication: Ann Arbor, Michigan : Grapho Publications LLC, [2015]- |
| مواضيع طبية MeSH: | Carcinoma, Non-Small-Cell Lung*/diagnostic imaging , Carcinoma, Non-Small-Cell Lung*/pathology , Carcinoma, Non-Small-Cell Lung*/surgery , Lung Neoplasms*/diagnostic imaging , Lung Neoplasms*/pathology , Lung Neoplasms*/surgery , Neoplasm Staging* , Neoplasm Micrometastasis*/diagnostic imaging , Neoplasm Micrometastasis*/pathology , Sentinel Lymph Node*/diagnostic imaging , Sentinel Lymph Node*/pathology , Sentinel Lymph Node Biopsy*/methods, Humans ; Pilot Projects ; Male ; Female ; Aged ; Middle Aged ; Lymphatic Metastasis/diagnostic imaging ; Lymphatic Metastasis/pathology ; Lymph Node Excision/methods ; Robotic Surgical Procedures/methods ; Tomography, X-Ray Computed/methods ; Tomography, Emission-Computed, Single-Photon/methods ; Nucleic Acid Amplification Techniques/methods ; Pneumonectomy/methods |
| مستخلص: | Lymphadenectomy represents a fundamental step in the staging and treatment of non-small cell lung cancer (NSCLC). To date, the extension of lymphadenectomy in early-stage NSCLC is a debated topic due to its possible complications. The detection of sentinel lymph nodes (SLNs) is a strategy that can improve the selection of patients in which a more extended lymphadenectomy is necessary. This pilot study aimed to refine lymph nodal staging in early-stage NSCLC patients who underwent robotic lung resection through the application of innovative intraoperative sentinel lymph node (SLN) identification and the pathological evaluation using one-step nucleic acid amplification (OSNA). Clinical N0 NSCLC patients planning to undergo robotic lung resection were selected. The day before surgery, all patients underwent radionuclide computed tomography (CT)-guided marking of the primary lung lesion and subsequently Single Photon Emission Computed Tomography (SPECT) to identify tracer migration and, consequently, the area with higher radioactivity. On the day of surgery, the lymph nodal radioactivity was detected intraoperatively using a gamma camera. SLN was defined as the lymph node with the highest numerical value of radioactivity. The OSNA amplification, detecting the mRNA of CK19, was used for the detection of nodal metastases in the lymph nodes, including SLN. From March to July 2021, a total of 8 patients (3 female; 5 male), with a mean age of 66 years (range 48-77), were enrolled in the study. No complications relating to the CT-guided marking or preoperative SPECT were found. An average of 5.3 lymph nodal stations were examined (range 2-8). N2 positivity was found in 3 out of 8 patients (37.5%). Consequently, pathological examination of lymph nodes with OSNA resulted in three upstages from the clinical IB stage to pathological IIIA stage. Moreover, in 1 patient (18%) with nodal upstaging, a positive node was intraoperatively identified as SLN. Comparing this protocol to the usual practice, no difference was found in terms of the operating time, conversion rate, and complication rate. Our preliminary experience suggests that sentinel lymph node detection, in association with the accurate pathological staging of cN0 patients achieved using OSNA, is safe and effective in the identification of metastasis, which is usually undetected by standard diagnostic methods. |
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| فهرسة مساهمة: | Keywords: NSCLC; OSNA; robotic surgery; sentinel lymph node |
| تواريخ الأحداث: | Date Created: 20240524 Date Completed: 20240524 Latest Revision: 20240526 |
| رمز التحديث: | 20240526 |
| مُعرف محوري في PubMed: | PMC11125324 |
| DOI: | 10.3390/tomography10050058 |
| PMID: | 38787018 |
| قاعدة البيانات: | MEDLINE |
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