Abstract

Background: The usefulness of Sentinel Lymph Node (SLN) biopsy in colorectal cancer remains controversial. This study aims to determine the feasibility of SLN in colorectal cancer staging.

Methods: Forty-one patients underwent resection had their lymphatic drainage system mapped by Blue-dye injection into submucosa overlying tumour site intraoperatively. The blue-stained SLN is identified and sent to pathology separately. The SLN were stained with Haematoxylin&Eosin (H&E) and Immunohistochemical (IHC) technique. Regional nodes (NSLN) in the tumour specimen were examined by H&E.

Results: SLN was demonstrated in 38/41 patients (92.6%). 2 of the 3 cases were positive for their NSLN. 27/38 SLN had negative H&E staining (71.1%). The 27 H&E negative SLN, 1 SLN was positive with IHC. 7 cases were positive both in SLN and NSLN (sensitivity = 46.6%, positive predictive value = 63.6%), whereas 4 cases were positive in SLN but negative in NSLN. 19 patients shared negative SLN and NSLN staining (specificity = 82.6%, negative predictive value = 70.3%), whereas 8 cases were NSLN-positive but negative in SLN.

Conclusions: SLN biopsy is feasible, but should only be used as an adjuvant staging method. A positive SLN avoids examination of NSLN. A negative SLN does not exclude positive NSLN.

Recommended Citation

Edmund Leung, James Francombe, Simon Chew, Peter Douglas, and Graham Newstead (2008) "The feasibility of sentinel lymph node biopsy in colorectal cancer staging," World Journal of Colorectal Surgery: Vol. 1 : Iss. 1, Article 19.
Available at: http://services.bepress.com/wjcs/vol1/iss1/art19