Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma

Claire King; Nusaybah Elsherif; Ruaidhrí Kirwan; Clare Schilling; Gillian Hall; Peter Morgan; Lisette Collins; Ann Sandison; Edward Odell; Selvam Thavaraj

doi:10.1002/hed.26784

Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma

Claire King, Nusaybah Elsherif, Ruaidhrí Kirwan, Clare Schilling, Gillian Hall, Peter Morgan, Lisette Collins, Ann Sandison, Edward Odell, Selvam Thavaraj

Research output: Contribution to journal › Article › peer-review

13 Citations (Scopus)

Abstract

BACKGROUND: Sentinel lymph node (SLN) biopsy is an accurate staging modality in early oral squamous cell carcinoma (OSCC), but its accuracy relies on labor-intensive histopathology protocols. We sought to determine whether serial step sections with immunohistochemistry (SSSIHC) at narrow intervals of the entire SLN are required to accurately exclude metastasis.

METHODS: Consecutive SLN biopsies over a 13-year period were retrospectively evaluated. If the index section was negative for carcinoma, the entire SLN was subjected to SSSIHC at 150 μm intervals. The first section level and total number of section levels to contain carcinoma were recorded.

RESULTS: One hundred and eighteen SLN+ from 90 patients were included. SSSIHC upstaged the nodal status in 19.5% of patients. Metastasis was identified in 16.7% and 10.2% beyond section levels 4 and 6, respectively. Among SLNs requiring SSSIHC, 47.5% contained carcinoma in a single section level.

CONCLUSION: SSSIHC of the entire SLN at 150 μm intervals are required to identify occult metastasis in OSCC.

Original language	English
Pages (from-to)	2985-2993
Number of pages	9
Journal	Head & Neck: journal for the sciences and specialities of the head and neck
Volume	43
Issue number	10
Early online date	15 Jun 2021
DOIs	https://doi.org/10.1002/hed.26784
Publication status	Published - Oct 2021

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10.1002/hed.26784

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King, C., Elsherif, N., Kirwan, R., Schilling, C., Hall, G., Morgan, P., Collins, L., Sandison, A., Odell, E., & Thavaraj, S. (2021). Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma. Head & Neck: journal for the sciences and specialities of the head and neck, 43(10), 2985-2993. https://doi.org/10.1002/hed.26784

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title = "Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma",

abstract = "BACKGROUND: Sentinel lymph node (SLN) biopsy is an accurate staging modality in early oral squamous cell carcinoma (OSCC), but its accuracy relies on labor-intensive histopathology protocols. We sought to determine whether serial step sections with immunohistochemistry (SSSIHC) at narrow intervals of the entire SLN are required to accurately exclude metastasis.METHODS: Consecutive SLN biopsies over a 13-year period were retrospectively evaluated. If the index section was negative for carcinoma, the entire SLN was subjected to SSSIHC at 150 μm intervals. The first section level and total number of section levels to contain carcinoma were recorded.RESULTS: One hundred and eighteen SLN+ from 90 patients were included. SSSIHC upstaged the nodal status in 19.5% of patients. Metastasis was identified in 16.7% and 10.2% beyond section levels 4 and 6, respectively. Among SLNs requiring SSSIHC, 47.5% contained carcinoma in a single section level.CONCLUSION: SSSIHC of the entire SLN at 150 μm intervals are required to identify occult metastasis in OSCC.",

author = "Claire King and Nusaybah Elsherif and Ruaidhr{\'i} Kirwan and Clare Schilling and Gillian Hall and Peter Morgan and Lisette Collins and Ann Sandison and Edward Odell and Selvam Thavaraj",

note = "Funding Information: The authors acknowledge the contribution of all biomedical science staff at Viapath Head & Neck Pathology, Guy's Hospital who undertook all laboratory technical work for this study. Publisher Copyright: {\textcopyright} 2021 The Authors. Head & Neck published by Wiley Periodicals LLC. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

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doi = "10.1002/hed.26784",

language = "English",

volume = "43",

pages = "2985--2993",

journal = "Head & Neck: journal for the sciences and specialities of the head and neck",

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King, C, Elsherif, N, Kirwan, R, Schilling, C, Hall, G, Morgan, P, Collins, L, Sandison, A, Odell, E & Thavaraj, S 2021, 'Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma', Head & Neck: journal for the sciences and specialities of the head and neck, vol. 43, no. 10, pp. 2985-2993. https://doi.org/10.1002/hed.26784

Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma. / King, Claire; Elsherif, Nusaybah; Kirwan, Ruaidhrí et al.
In: Head & Neck: journal for the sciences and specialities of the head and neck, Vol. 43, No. 10, 10.2021, p. 2985-2993.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma

AU - King, Claire

AU - Elsherif, Nusaybah

AU - Kirwan, Ruaidhrí

AU - Schilling, Clare

AU - Hall, Gillian

AU - Morgan, Peter

AU - Collins, Lisette

AU - Sandison, Ann

AU - Odell, Edward

AU - Thavaraj, Selvam

N1 - Funding Information: The authors acknowledge the contribution of all biomedical science staff at Viapath Head & Neck Pathology, Guy's Hospital who undertook all laboratory technical work for this study. Publisher Copyright: © 2021 The Authors. Head & Neck published by Wiley Periodicals LLC. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/10

Y1 - 2021/10

N2 - BACKGROUND: Sentinel lymph node (SLN) biopsy is an accurate staging modality in early oral squamous cell carcinoma (OSCC), but its accuracy relies on labor-intensive histopathology protocols. We sought to determine whether serial step sections with immunohistochemistry (SSSIHC) at narrow intervals of the entire SLN are required to accurately exclude metastasis.METHODS: Consecutive SLN biopsies over a 13-year period were retrospectively evaluated. If the index section was negative for carcinoma, the entire SLN was subjected to SSSIHC at 150 μm intervals. The first section level and total number of section levels to contain carcinoma were recorded.RESULTS: One hundred and eighteen SLN+ from 90 patients were included. SSSIHC upstaged the nodal status in 19.5% of patients. Metastasis was identified in 16.7% and 10.2% beyond section levels 4 and 6, respectively. Among SLNs requiring SSSIHC, 47.5% contained carcinoma in a single section level.CONCLUSION: SSSIHC of the entire SLN at 150 μm intervals are required to identify occult metastasis in OSCC.

AB - BACKGROUND: Sentinel lymph node (SLN) biopsy is an accurate staging modality in early oral squamous cell carcinoma (OSCC), but its accuracy relies on labor-intensive histopathology protocols. We sought to determine whether serial step sections with immunohistochemistry (SSSIHC) at narrow intervals of the entire SLN are required to accurately exclude metastasis.METHODS: Consecutive SLN biopsies over a 13-year period were retrospectively evaluated. If the index section was negative for carcinoma, the entire SLN was subjected to SSSIHC at 150 μm intervals. The first section level and total number of section levels to contain carcinoma were recorded.RESULTS: One hundred and eighteen SLN+ from 90 patients were included. SSSIHC upstaged the nodal status in 19.5% of patients. Metastasis was identified in 16.7% and 10.2% beyond section levels 4 and 6, respectively. Among SLNs requiring SSSIHC, 47.5% contained carcinoma in a single section level.CONCLUSION: SSSIHC of the entire SLN at 150 μm intervals are required to identify occult metastasis in OSCC.

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U2 - 10.1002/hed.26784

DO - 10.1002/hed.26784

M3 - Article

C2 - 34128276

SN - 1043-3074

VL - 43

SP - 2985

EP - 2993

JO - Head & Neck: journal for the sciences and specialities of the head and neck

JF - Head & Neck: journal for the sciences and specialities of the head and neck

IS - 10

ER -

King C, Elsherif N, Kirwan R, Schilling C, Hall G, Morgan P et al. Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma. Head & Neck: journal for the sciences and specialities of the head and neck. 2021 Oct;43(10):2985-2993. Epub 2021 Jun 15. doi: 10.1002/hed.26784

Serial step sections at narrow intervals with immunohistochemistry are required for accurate histological assessment of sentinel lymph node biopsy in oral squamous cell carcinoma

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