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Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma
Author(s) -
King Claire,
Elsherif Nusaybah,
Kirwan Ruaidhrí,
Schilling Clare,
Hall Gillian,
Morgan Peter,
Collins Lisette,
Sandison Ann,
Odell Edward,
Thavaraj Selvam
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26784
Subject(s) - sentinel lymph node , medicine , biopsy , metastasis , histopathology , carcinoma , occult , pathology , basal cell , immunohistochemistry , radiology , cancer , breast cancer , alternative medicine
Background Sentinel lymph node (SLN) biopsy is an accurate staging modality in early oral squamous cell carcinoma (OSCC), but its accuracy relies on labor‐intensive histopathology protocols. We sought to determine whether serial step sections with immunohistochemistry (SSSIHC) at narrow intervals of the entire SLN are required to accurately exclude metastasis. Methods Consecutive SLN biopsies over a 13‐year period were retrospectively evaluated. If the index section was negative for carcinoma, the entire SLN was subjected to SSSIHC at 150 μm intervals. The first section level and total number of section levels to contain carcinoma were recorded. Results One hundred and eighteen SLN+ from 90 patients were included. SSSIHC upstaged the nodal status in 19.5% of patients. Metastasis was identified in 16.7% and 10.2% beyond section levels 4 and 6, respectively. Among SLNs requiring SSSIHC, 47.5% contained carcinoma in a single section level. Conclusion SSSIHC of the entire SLN at 150 μm intervals are required to identify occult metastasis in OSCC.