Table 4
Summary of non-duplicate lymphatic mapping and SN biopsy studies in CRCs
| First author, year (ref) | Number of cases | Identification rates | False negative rates | Upstaged by enhanced SN pathology | Method used | Comment (definition of SNs, range of SNs, pathology details) |
|---|---|---|---|---|---|---|
| The false negative rate is defined as the number of SN negative but LN positive cases divided by the number of all LN positive cases. The upstaging rate is defined as the number of SN positive cases positive by enhanced pathology only divided by the number of cases found to be SN negative by standard assessment. | ||||||
| CK, cytokeratin; CRC, colorectal cancer; HE, haematoxylin and eosin; IHC, immunohistochemistry; LN, lymph node; NA, not applicable; NI, not indicated; RT-PCR, reverse transcription polymerase chain reaction; SN, sentinel node; SS, serial sections. | ||||||
| Thörn, 2000 (93) | 10 | 10/10 (100%) | 1/? (≥10%) | NI | Subserosal dye and radiocolloid in vivo, in vivo search for blue SNs and ex vivo search for radioactive SNs | Any blue LN identified in vivo and high activity LNs defined as SN (range, NI); pathology details NI |
| Evangelista, 2002 (94) | 11 | 10/11 (91%) | 1/3 (33%) | NA | Subserosal dye (submucosal for distal rectal cancers) in vivo, in vivo search for LNs | First to third blue LN defined as SN (range, 0–3); HE of all LNs |
| Tsoulias, 2002 (95) | 14 | 14/14 (100%) | 1/3 (33%) | 2/13 (15%) | Endoscopic submucosal dye in vivo, in vivo laparoscopic search for SNs | First blue LNs defined as SNs (range, 1–3); SS, IHC of SNs |
| Bendavid, 2002 (96) | 20 | 18/20 (90%) | 0/12? (0%) | 5/11? (45%) | Subserosal dye in vivo, in vivo search for SNs | Any blue LN defined as SN (range, NI; mean, 3.9); SS, IHC of SNs |
| Waters, 2000 (97) | 22 | 20/22 (91%) | 2/3 (66%) HE 0/6 (0%) IHC | 1/15 (7%) | Subserosal dye in vivo, in vivo search for SNs | Any blue LN identified in vivo defined as SN (range, NI); IHC of HE negative SNs |
| Cserni, 1999 (38) | 25 | 24/25 (96%) | 5/13 (38%) HE | NA | Subserosal dye in vivo, ex vivo search for SNs | Any blue LN (range, 0–12) defined as possible SN; HE staining of all LNs |
| Merrie, 2001 (90) | 26 | 23/26 (88%) | 3/7 (43%) HE 5/11 (45%) RT–PCR | 2/16 (13%) | Subserosal dye and radiocolloid in vivo, ex vivo search for SNs | High radioactivity LNs or first blue LNs by tracing efferent and afferent lymphatic vessels (range, 0–8); HE and CK-20 RT-PCR of half LNs for all LNs |
| Wong, 2001 (98) | 26 | 24/26 (92%) | 5/12 (42%) HE 1/16 (6%) IHC | 4/12 (33%) | Submucosal dye ex vivo, then search for SNs | Any blue LN defined as SN (range, 0–6); IHC of negative SNs |
| Firtzgerald, 2002 (99) | 26 | 23/26 (88%) | 2/7 (29%) IHC | 2/20 (10%) | Subserosal dye (submucosal for rectal cancers) ex vivo, search for blue LNs | Any blue LN defined as SN (range, NI);3 level HE and IHC of SNs |
| Esser, 2001 (100) | 31 | 18/31 (58%) | 1/3 (33%) | NA | Subserosal dye in vivo (ex vivo for distal rectal cancers, ex vivo search for SNs | Any blue LN defined as SN (range, NI); HE for all LNs |
| Kitagawa, 2000 (101) | 33 | 28/33 (85%) | 2/8 (25%) | NA | Endoscopic submucosal radiocolloid in vivo, in vivo search for SNs | Radioactive LNs defined as SNs (range, NI; mean, 3.7); HE for all LNs |
| Feig, 2001 (102) | 48 | 47/48 (98%) | 10/16 (63%) HE 5/20 (20%) IHC | 4/31 (13%) | Subserosal dye in vivo, in vivo and ex vivo search for blue LNs | Any blue LN defined as SN (range, 0–7); SS and IHC of SNs |
| Joosten, 1999 (61) | 50 | 35/50 (70%) | 12/20 (60%) HE | 2/15 (13%) | Subserosal dye (submucosal for distal rectal cancers) in vivo, ex vivo search for blue LNs | Any blue LN defined as SN (range, 0–16); CK IHC of HE negative blue LNs |
| Paramo, 2002 (103) | 55 | 45/55 (82%) | 1/15 (7%) | 6/36 (17%) | Subserosal dye in vivo, in vivo search for SNs | First 1–4 blue LNs defined as SNs (range, 0–1); SS, IHC of SNs |
| Bilchik, 2002 (86) | 100 | 97/100 (97%) | 5/26 (19%) HE | 18/74 (24%) 2 levels HE and IHC 12/26 (46%) RT–PCR of IHC negative SNs | Subserosal dye in vivo, in vivo search for SNs, or salvage subserosal or submucosal dye ex vivo, for failed procedures | Any blue LN defined as SN (range, NI); SS, IHC and/or RT-PCR of SNs |
| Saha, 2000 (92, 104) | 131 | 130/131 (99%) | 4/51 (8%) | 6/86 (7%) | Subserosal dye in vivo, in vivo search for SNs | First 1–4 blue staining LNs defined as SNs (range, 0–4); SS and IHC of HE negative SNs |
