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Cirugía y cirujanos
versão On-line ISSN 2444-054Xversão impressa ISSN 0009-7411
Resumo
GARCIA-MEJIDO, José A. et al. Can clinicopathological factors improve the prediction of metastasis to nonsentinel lymph nodes in patients with breast cancer?. Cir. cir. [online]. 2022, vol.90, n.4, pp.473-480. Epub 19-Ago-2022. ISSN 2444-054X. https://doi.org/10.24875/ciru.21000148.
Introduction:
To determine whether clinicopathological characteristics can improve the prediction of metastasis to nonsentinel lymph nodes (NSLNs) over the use of only mRNA copy number in sentinel lymph node (SLN) biopsies.
Methods:
This was a retrospective, observational study that included a total of 824 patients with T1-3 breast cancer who had clinically negative, ultrasound-negative axilla without evidence of metastasis and who underwent one-step nucleic acid amplification in SLN biopsies.
Results:
118 required a complete axillary lymph node dissection (ALNhD). About 35.6% (42/118) had metastases to a NSLN, and 64.4% (76/118) had no metastasis to a NSLN. The ROC curve of the total tumor load (TTL) presented an area under the curve (AUC) of 0.651 (95%; CI: 0.552-0.751). The 7294 copies of CK19 mRNA were established as the optimal cutoff point, with sensitivity: 93%, specificity: 63%, positive predictive value: 44%, and negative predictive value: 91%. By associating the clinicopathological parameters (multicentricity, pooled immunohistochemistry [IHC], and progesterone receptors), the AUC went up to 0.752 (95% CI: 0.663-0.841).
Conclusions:
Clinicopathological factors should be considered together with the total CK19 mRNA copy number (the TTL) of the SLNs to improve the predictive capacity of metastatic involvement of the NSLNs.
Palavras-chave : Carcinoma breast cancer; Sentinel lymph node/SLN; Nucleic acid amplification/OSNA; Tumor load CK19.