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Intraoperative detection of sentinel lymph nodes using Patent Blue V in non-small cell lung cancer
M E F Bustos1, J J P Camargo, G Resin Geyer
1Department of Thoracic Surgery, Pavilhão Pereira Filho Hospital, Santa Casa de Porto Alegre, Porto Alegre, Brazil.
Aim:
The aim of this article was to determine sentinel lymph node (SLN) identification rate (IR) using Patent Blue V in patients with non-small cell lung cancer (NSCLC) and to evaluate the accuracy of SLN for the presence of mediastinal metastasis.
Methods:
Between 2004 and 2006 the data from 32 patients with clinical stage IA to IIB, who underwent lung resection for NSCLC, were prospectively analyzed. Patent blue V dye was injected in the peritumoral tissue, and the first lymph node to stain was identified as a sentinel node.
Results:
SLN was identified in fifteen patients (IR=46.9%). SLN with metastatic involvement was observed in four patients. Accuracy, sensitivity and specificity of the sentinel lymph node in predicting the status of other mediastinal lymph node stations were respectively 86.7%, 100%, and 84.6%. In 63.1% patients, the SLNs corresponded to the lymph node stations 10 and 11. In seven patients (36.9%), the SLNs were located in the N2 stations.
Conclusion:
Although the use of Patent Blue V for SLN identification is feasible, this technique presents relatively low identification rate. The major difficulty on the detection of SLNs was the black coloration of the lymph node, which interfered with the visualization of the dye.
