¿Pueden los factores clínicopatológicos mejorar la predicción de metástasis en ganglios linfáticos no centinelas en pacientes con cáncer de mama?

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...

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Detalles Bibliográficos
Autores: García Mejido, José A., Sánchez Sevilla, Miguel, González Martínez, Jesús, Fernández Palacín, Ana, Sainz Bueno, José A.
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/189567
Acceso en línea:https://hdl.handle.net/2445/189567
Access Level:acceso abierto
Palabra clave:Càncer de mama
Ganglis sentinelles
Breast cancer
Sentinel lymph nodes
Descripción
Sumario: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 biop-sies. 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 as-sociating 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.