Sentinel node theory helps tracking of primary lesions of cancers of unknown primary View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-07-09

AUTHORS

Yilin Shao, Xin Liu, Silong Hu, Yingjian Zhang, Wentao Li, Xiaoyan Zhou, Qifeng Wang, Yifeng Hou, Yong Chen, Yanli Wang, Yaohui Wang, Zhiguo Luo, Xichun Hu

ABSTRACT

BACKGROUND: Sentinel lymph node is the first stop of lymphatic spreading of cancer with known primary. The lymph node metastasis pattern of cancer of unknown primary (CUP) is unclear and has been presumed to follow the same pathway. To test this hypothesis, data of all 716 patients clinically diagnosed as CUP in our center were collected. METHODS: Diagnoses of lymph node metastasis were established by 18F-FDG PET-CT and/or biopsy pathology. Three hundred and forty-seven cases meeting the criteria were divided into three groups: pathology-confirmed primary with invasive biopsy or surgery of the suspicious lesion (group A, n = 64), primary still unknown even with invasive biopsy or surgery of the suspicious lesion (group B, n = 204), and others with no suspicious lesion or lesions who had not been sampled due to medical or other reasons (group C, n = 79). We assessed the clinicopathological features between these groups, and the relationship between lymph node metastasis pattern and confirmed primary site. RESULTS: In group A, the primary sites of 61 cases were compatible with sentinel node theory, resulting in a positive predictive value of 95%. No significant differences in age, sex, bone metastasis, or visceral metastasis observed between group A and group B, except that group A had a higher ratio of differentiated carcinoma (94% vs. 77%, P = 0.003). CONCLUSION: To our knowledge, this is the first evidence indicating that the majority of clinical CUP cases follow the sentinel node theory to spread in lymph nodes, which helps tracking the primary, especially for differentiated carcinoma. More... »

PAGES

639

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12885-020-07042-6

DOI

http://dx.doi.org/10.1186/s12885-020-07042-6

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1129131046

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32646508


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33 schema:description BACKGROUND: Sentinel lymph node is the first stop of lymphatic spreading of cancer with known primary. The lymph node metastasis pattern of cancer of unknown primary (CUP) is unclear and has been presumed to follow the same pathway. To test this hypothesis, data of all 716 patients clinically diagnosed as CUP in our center were collected. METHODS: Diagnoses of lymph node metastasis were established by <sup>18</sup>F-FDG PET-CT and/or biopsy pathology. Three hundred and forty-seven cases meeting the criteria were divided into three groups: pathology-confirmed primary with invasive biopsy or surgery of the suspicious lesion (group A, n = 64), primary still unknown even with invasive biopsy or surgery of the suspicious lesion (group B, n = 204), and others with no suspicious lesion or lesions who had not been sampled due to medical or other reasons (group C, n = 79). We assessed the clinicopathological features between these groups, and the relationship between lymph node metastasis pattern and confirmed primary site. RESULTS: In group A, the primary sites of 61 cases were compatible with sentinel node theory, resulting in a positive predictive value of 95%. No significant differences in age, sex, bone metastasis, or visceral metastasis observed between group A and group B, except that group A had a higher ratio of differentiated carcinoma (94% vs. 77%, P = 0.003). CONCLUSION: To our knowledge, this is the first evidence indicating that the majority of clinical CUP cases follow the sentinel node theory to spread in lymph nodes, which helps tracking the primary, especially for differentiated carcinoma.
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41 FDG PET-CT
42 PET-CT
43 age
44 biopsy
45 biopsy pathology
46 bone metastases
47 cancer
48 carcinoma
49 cases
50 center
51 clinical CUP cases
52 clinicopathological features
53 criteria
54 cup
55 data
56 diagnosis
57 differences
58 differentiated carcinoma
59 evidence
60 features
61 first evidence
62 first stop
63 group
64 group A
65 group B
66 high ratio
67 hypothesis
68 invasive biopsy
69 knowledge
70 lesions
71 lymph
72 lymph node metastasis
73 lymph node metastasis patterns
74 lymph nodes
75 lymphatic spreading
76 majority
77 metastasis
78 metastasis pattern
79 node metastasis
80 node metastasis pattern
81 node theory
82 nodes
83 pathology
84 pathology-confirmed primary
85 pathway
86 patients
87 patterns
88 positive predictive value
89 predictive value
90 primary
91 primary lesion
92 primary site
93 ratio
94 reasons
95 relationship
96 same pathway
97 sentinel lymph nodes
98 sentinel node theory
99 sex
100 significant differences
101 sites
102 spreading
103 stops
104 surgery
105 suspicious lesions
106 theory
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108 unknown primary
109 values
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