دقت تشخيص روش هاي Touch imprint و Frozen section در تعيين درگيري غدد لنفاوي مدياستن در كانسر ريه

Diagnostic accuracy of touch imprint and frozen section analysis in mediastinal lymph node involvement: lung cancer patients

Background: It is well known that, at the time of the initial prese ntatio n of pati en ts with non- small cell lung cancer, N-starus is very imp ortant in accurate stagi ng and avo idi ng inappropriate sur gical pro cedures. Also, if medi astin al lymph node metasta sis (N2) of non- small ce ll lung ca ncer (stage mA) is present , neoadjuvant (preoperative) che rnoradiotherapy is indi cat ed; therefore a quick and accurate N-s tatus determinati on is criti cal before thoracotomy. We comp ared the usefulness and acc uracy of touch imprint and froze n section analys is for this purp ose. Methods: During 2006, fifty eight medi astin al lymph node spec imens from 27 pat ient s with lung cancer wer e excised. After touch impr int prep aration , hal f of eac h lymph node was sent for frozen sec tion and fin ally perman ent histology. Results: Frozen sec tion and touch imprint had only one and two false negati ve result s, respectively, but neither had false positi ve reports. Th e se nsi tivity, speci fic ity and accu racy of the frozen sec tion evaluation was 95.5%, 100% and 98.2%, respec tively, and those of touch impr int were, 90.9%, 100% and 96.4%. The di fferen ces in the sens itivity , specific ity and acc uracy between the two meth ods were not significant (p>0.05). Conclusion: Froze n se ction and touch imprint have similarly high accuracies for detectin g medi ast inal lymph node metasta si s in lung cance r. However , sin ce the touch impr int method is more rapid and simple, it mayb e meth od of choice .