PS02.079: ESOPHAGEAL ADENOCARCINOMA: CT, PET, EUS SENSITIVITY/SPECIFICITY FOR THE PREOPERATIVE ASSESSMENT OF LYMPH NODE METASTASES IN SINGLE THORACIC AND ABDOMINAL NODAL STATIONS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 142-143
Author(s):  
Juha Kauppi ◽  
Marialuisa Lugaresi ◽  
Egesta Lopci ◽  
Niccolò Daddi ◽  
Jari Räsänen ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Esophageal Adenocarcinoma ◽  
Preoperative Staging ◽  
False Negative ◽  
Clinical Staging ◽  
Lymph Node Status ◽  
True Positive ◽  
True Negative ◽  
Sensitivity Specificity

Abstract Background In esophageal adenocarcinoma clinical staging (cStaging), interest for N-descriptor according to single lymph nodal station has emerged, but no specific data are available. CT, PET, EUS sensitivity/specificity for N-descriptor in single stations were investigated. Methods In 101 esophageal adenocarcinoma cases (60/41 Siewert I/II) preoperative staging and primary radical surgical resection (prospective protocols) were performed. Resected lymphatic nodes (LNY) and lymphatic metastases (LNM) were reported for the following stations: A) right paratracheal/sub carinal/pulmonary ligament; B) paraesophageal thoracic; C) pericardial; D) left gastric artery, lesser curvature; E) celiac trunk, hepatic/splenic artery. Pathological N data were compared with clinical N-descriptors. Results LN stations: A) LNY 137 LNM 6, Sensitivity CT 58.3%, PET 7.1%, EUS 87.5%—Specificity CT 94.3%, PET 98.8%, EUS 88.6%; B) LNY 79 LNM 18, Sensitivity CT 33.3%, PET 20%, EUS 80%—Specificity CT 92.1%, PET 96.6%, EUS 87.2%; C) LNY189 LNM 36, Sensitivity CT 46.6%, PET 23.5%, EUS 28.5%—Specificity CT 95.3%, PET 97.5%, EUS 97.7%; D) LNY 383 LNM 66, Sensitivity CT 24.1%, PET 21.4%, EUS 33.3%—Specificity CT 97.2%, PET 97.2%, EUS 100%; E) LNY 148 LNM 17, Sensitivity CT 13.3%, PET 5.5%, EUS 33.3%—Specificity CT 93%, PET 98.7%, EUS 95.2%. Figure Staging in adenocarcinoma of the esophageal-gastric junction; CT (A), PET (B) and fused PET/CT sessions (C) at the level of the primary tumor (red arrows) and para-esophageal lymph nodes including one PET-positive (red arrowheads), and one PET-negative detectable on CT only (yellow arrowheads). Panel D the box-plot for median SUVmax according to pathologic lymph node status. In the true positive lymph nodes, SUVmax was significantly higher than in true negative (median, 13.6 vs 5.0, P = 0.001) and false negative lymph nodes (median, 13.6 vs 6.9; P = 0.026). Abbreviations: FN = false negative; TP = true positive; TN = true negative. Conclusion For esophageal adenocarcinoma cStaging, CT, PET, EUS N-descriptor is not reliable, particularly PET data for N stations close to primary T. To tailor therapy, new biological descriptors are necessary. Disclosure All authors have declared no conflicts of interest.

P219 THE ROLE OF PET-CT IN THE EVALUATION OF LYMPH NODE INVOLVEMENT IN ESOPHAGEAL AND GASTROESOPHAGEAL JUNCTION CARCINOMA - A 5-YEAR SINGLE CENTER EXPERIENCE

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
Chrysovalantis Vergadis ◽  
Eustratia Mpaili ◽  
Athanasios Syllaios ◽  
Maria Mpoura ◽  
Adamantios Michalinos ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
False Positive ◽  
Gastroesophageal Junction ◽  
Preoperative Staging ◽  
False Negative ◽  
Clinical Staging ◽  
Lymph Node Status ◽  
Pathology Report ◽  
Pet Ct

Abstract Aim To determine the efficacy of positron emission tomography-computed tomography (PET-CT) in the evaluation of lymph node status during preoperative staging on patients with esophageal and gastrοesophageal junction carcinoma compared to the final histopathological findings. Background & Methods Data on patients that underwent esophagectomy from 01/03/2014 to 01/03/2019 were prospectively collected and retrospectively reviewed. Based on the medical records, the following parameters were extracted and analyzed: patient demographics, histopathological parameters, surgical and oncological outcomes. All patients were staged according to the AJCC 8th edition. Results A total of 79 patients underwent Ivor Lewis or McKeown esophagectomy for either squamous cell carcinoma (n= 7 patients) or adenocarcinoma of esophagus or gastroesophageal junction (n= 72 patients). In 60 cases, clinical staging was conducted without performing PET- CT, while 19 cases underwent PET-CT. Among the 19 patients, 16 (84.2%) were men, and 3 (15.8 %) were women. Mean age was 62 years, (range 41- 72). Mean nodal harvest per patient was 30.6 lymph nodes. Twelve out of 19 patients (63.2%) revealed lymph node invasion, with a mean of 5.6 positive lymph nodes per patient. PET-CT identified the primary tumor in all 19 patients (100%). PET-CT demonstrated 100% compliance with the final histopathological reports regarding N status in only 5 out of 19 cases (26.3%). Four patients were staged as N0 both pre- and postoperatively, while one was deemed positive by PET-CT in right paracardial lymph nodes which was histopathologically confirmed. In other 4 patients (21.1%), PET-CT was 100% false negative, whereas in 3 patients (15.8%) PET-CT was 100% false positive. In the remaining 7 patients, PET-CT findings were in accordance with the pathology report in 7 out of 25 examined lymph node stations, false positive in 9 out of 25 and false negative in 9 out of 25. Conclusion PET-CT seems to have a considerable number of false positive and false negative results in esophageal cancer in our study as far as N-staging is concerned. Further studies with larger sample size are needed to reach more conclusive results.

Determinants of False-Negative Fine-Needle Aspirates of Axillary Lymph Nodes in Women with Breast Cancer: Lymph Node Size, Cortical Thickness and Hilar Fat Retention

2015 ◽  
Vol 59 (4) ◽  
pp. 311-314 ◽  
Author(s):  
D. Eric Ewing ◽  
Lester J. Layfield ◽  
Christopher L. Joshi ◽  
Mark D. Travis
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Cortical Thickness ◽  
False Negative ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
True Positive ◽  
False Negatives ◽  
Lymph Node Size ◽  
Node Size

Objective: Ultrasound-guided fine-needle aspiration (UG-FNA) is utilized to sample axillary lymph nodes in breast cancer patients. Diagnostic sensitivity is good but few data exist regarding the causes of false-negative results. Study Design: Fifty-four UG-FNAs of sentinel lymph nodes with histologic follow-up were identified. Gross and radiographic lymph node size, the percentage replaced by carcinoma and the cortical thickness were correlated with false-negative rates. Results: Thirty-seven aspirates were negative, 5 of these being false-negative (9%). True-positive lymph nodes averaged 1.3 cm in dimension while false-negatives averaged 0.92 cm. Percentage involvement by carcinoma for true-positive FNAs averaged 69% while false-negatives averaged 25%. Cortical thickness averaged 5.6 mm in true-positive FNAs but 2.9 mm in false-negatives. Conclusion: A relationship exists between lymph node size and the likelihood of a false-negative FNA. Lymph nodes <1.2 cm have a higher incidence of false-negative results. Lymph nodes with <30% involvement demonstrated a higher percentage of false-negatives than those with >30% replacement. Sentinel lymph nodes <1 cm appear to be relatively poor candidates for UG-FNA. Lymph nodes with a cortical thickness <3.5 mm are more often associated with a false-negative result than nodes with a thicker cortex.

Sentinel lymph node in endometrial cancer

2007 ◽  
Vol 17 (5) ◽  
pp. 1113-1117 ◽  
Author(s):  
L.A.F Lopes ◽  
S. M Nicolau ◽  
F. F Baracat ◽  
E. C Baracat ◽  
W. J Gonçalves ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Sentinel Node ◽  
Endometrial Carcinoma ◽  
Frozen Section ◽  
False Negative ◽  
Pelvic Lymphadenectomy ◽  
Clinical Staging ◽  
Blue Dye

The aim of this study was to evaluate the possibility of identifying the sentinel lymph node and involvement of neoplastic cells in patients with endometrial carcinoma limited to the uterus, and also its correlation with the conditions of other pelvic and para-aortic lymph nodes. Forty patients with endometrial carcinoma, clinical staging I and II, were submitted to complete surgical staging through laparotomy, as recommended by FIGO in 1988. The sentinel node was investigated using patent blue dye in the myometrial subserosa. The sentinel node was excised and submitted to frozen section examination of specimen, stained with hematoxylin and eosin (H&E). Afterward, selective bilateral para-aortic and pelvic lymphadenectomy, total hysterectomy with bilateral salpingo-oophorectomy were performed. The lymph nodes excised were examined by means of paraffin-embedded slices stained with H&E and of imunohistochemistry with antikeratin antibody AE1/AE3. The sentinel lymph node was identified in 77.5% of patients (31/40), and 16.1% (5/31) presented neoplastic involvement in the node. In 25 cases of negative sentinel node, 96% (24/25) had no neoplastic involvement, and 4% (1/25) had other lymph node affected (false negative). In nine cases with no sentinel node identified, 55.5% (5/9) had lymph node involvement. The results of this study allow us to conclude that it is possible to identify the sentinel node using the methods described, and the pathologic examination significantly represents the same conditions of other pelvic and para-aortic lymph nodes.

Effects of variation of sentinel lymph nodes submitted during breast cancer sugery: Analysis of practice variation and costs.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 94-94 ◽  
Author(s):  
Louis H. Barr ◽  
Meiling Wu ◽  
Yai-Ping Mimi Shao ◽  
Xiang Zhu
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
False Negative ◽  
Sentinel Lymph Nodes ◽  
Lymph Node Status ◽  
Negative Number ◽  
Pathologic Evaluation ◽  
Negative Rate ◽  
Retrospective Examination

94 Background: Routine node evaluation involves simple bivalving the node with slides made from the resultant surfaces. SLNs are more thoroughly evaluated with 2-3 mm slices and histologic evaluation of each slice, resulting in many more slides to review. These slides would often have immunohistochemical analysis adding to the time and cost. In early studies of SLN efficacy and accuracy, the mean number of nodes was between 2 and 3 per patient though with some variation. As the number of submitted SLNs increases, the concern of benefit of the procedure comes into question. This is a retrospective examination of all SLN procedures for the year 2012 to examine the variation in the number of SLNs submitted for focused pathologic evaluation. Variation in the number of nodes submitted by surgeon is determined along with the associated costs of the pathologic evaluation. In addition, intraoperative evaluation of lymph node status may be useful to allow for immediate axillary node dissection during the initial operation. Utilization of this procedure was also examined to determine ultimate correlation with permanent pathologic evaluation. Methods: Retrospective examination of all breast cancer patients >=18 yrs who underwent SLN procedures during 2012. Introperative evaluation of lymph node for metastatic disease was also examined for correlation with permanent pathologic result. Results: 259 cases among 21 surgeons had touch prep performed. True positive number: 29. True negative number: 224. False negative number: 6. Fasle negative rate (FNR): 17.14%. Cost Effectiveness Evaluation: CPT 88307 - surg path gross and micro level V. CPT 88342 - Immunohistochemistry. CPT 88333 - Touch Prep. Pathologist time: 30 minutes per case. Conclusions: There is significant variation among surgeons as to number of cases and number of nodes submitted. There is a significantly greater number of sentinel lymph nodes examined by the pathologist as compared to the number of nodes submitted by the surgeon. The frequency of outliers is infrequent, but when it occurs there is significant cost in terms of time and dollars. The false negative rate from pathological evaluation is under study for isolated tumor cells.

scholarly journals Comparison of diagnostic accuracy of papanicoloau (PAP) Smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma, taking biopsy as gold standard.

2020 ◽  
Vol 27 (04) ◽  
pp. 863-869
Author(s):  
Shakila Yasmin ◽  
Tahira Munir ◽  
Ayesha Javaid ◽  
Khalid Fahim Yasin ◽  
Junaid Hassan
Keyword(s):  
Acetic Acid ◽  
Diagnostic Accuracy ◽  
Cervical Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
False Negative ◽  
True Positive ◽  
True Negative ◽  
Sensitivity Specificity

Study Design: Cross-sectional descriptive study. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital, Bahawalpur. Period: 05 August 2016 to 05 Feb 2017. Material & Methods: A total of 228 suspected patients of cervical carcinoma and age of 20-50 years were included. Patients with acute cervicitis, pregnant females, h/o abnormal cytology and obvious lesion on cervix were excluded. All the patients were underwent papanicoloau (PAP) smear and visual inspection using acetic acid. The results of papanicoloau (PAP) smear and visual inspection using acetic acid (VIA) were compared with cervical biopsy report. Results: In 110 papanicoloau (PAP) smear positive patients, 97 were True Positive and 13 were False Positive. Among, 118 papanicoloau (PAP) smear negative patients, 18 were False Negative whereas 100 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of papanicoloau ( PAP )smear in screening of cervical carcinoma was 84.35%, 88.50%, 88.18%, 84.75% and 86.40% respectively. In 114 visual inspection using acetic acid (VIA) positive patients, 95 were True Positive and 19 were False Positive. Among, 114 visual inspection using acetic acid (VIA) negative patients, 20 were False Negative whereas 94 were True Negative. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of visual inspection using acetic acid ( VIA) in  screening of cervical carcinoma was 82.61%, 83.19%, 83.33% 82.46% and 82.89% respectively. Conclusion: This study concluded that papanicoloau ( PAP) smear and visual inspection using acetic acid (VIA) in screening of cervical carcinoma are highly sensitive, accurate and having almost equal diagnostic accuracy.

scholarly journals Classification of Cancer of The Lungs Using SVM and ANN

2015 ◽  
Vol 15 (1) ◽  
pp. 6418-6426 ◽  
Author(s):  
Olusayo Deborah Fenwa ◽  
Funmilola A. Ajala ◽  
Adebisi A. Adigun
Keyword(s):  
Lung Diseases ◽  
Human Life ◽  
False Negative ◽  
Accurate Diagnosis ◽  
Lung Nodules ◽  
True Positive ◽  
True Negative ◽  
Diagnosis Of Cancer ◽  
Sensitivity Specificity

Accurate diagnosis of cancer plays an important role in order to save human life. The results of the diagnosis indicate by the medical experts are mostly differentiated based on the experience of different medical experts. This problem could risk the life of the cancer patients. A fast and effective method to detect the lung nodules and separate the cancer images from other lung diseases like tuberculosis is becoming increasingly needed due to the fact that the incidence of lung cancer has risen dramatically in recent years and an early detection can save thousands of lives each year. The focus of this paper is to compare the performance of the ANN and SVM classifiers on acquired online cancer datasets. The performance of both classifiers is evaluated using different measuring parameters namely; accuracy, sensitivity, specificity, true positive, true negative, false positive and false negative.

scholarly journals Limited Positive Predictive Value of β-d-Glucan in Hematologic Patients Receiving Antimold Prophylaxis

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Euijin Chang ◽  
Taek Soo Kim ◽  
Chang Kyung Kang ◽  
Kang Il Jun ◽  
Dongyeop Shin ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Diagnostic Value ◽  
Tertiary Hospital ◽  
True Positive ◽  
True Negative ◽  
Cell Transplants ◽  
Sensitivity Specificity ◽  
Low Prevalence

Abstract Background Diagnostic value of β-d-glucan (BDG) in populations with low prevalence of invasive fungal infection (IFI), such as hematologic patients receiving antimold prophylaxis, should be re-evaluated. Methods We retrospectively reviewed episodes with BDG results in hematologic patients receiving antimold prophylaxis from January 2017 to August 2019 in a tertiary hospital. The episodes were classified as true positive ([TP] positive BDG with IFI), true negative ([TN] negative BDG without IFI), false positive ([FP] positive BDG without IFI), false negative ([FN] negative BDG with IFI), and nonevaluable. Results A total of 203 episodes were analyzed: 101 episodes (49.8%) were from stem cell transplants, 89 (43.8%) were from induction chemotherapy, and 13 (6.4%) were from graft-versus-host disease treatment. There were 62 nonevaluable episodes. Among 141 evaluable ones, there were 8 (5.7%) episodes of probable/proven IFI. True positive, TN, FP, and FN cases were 4 (2.8%), 112 (79.4%), 21 (14.9%), and 4 (2.8%) episodes, respectively. Sensitivity, specificity, positive predictive value, and negative predictive value were 50.0%, 84.2%, 16.1%, and 96.5%, respectively. Positive predictive value was 26.7% and 0.0% in diagnostic and surveillance episodes, respectively. Conclusions β-d-glucan test should be used to exclude IFI rather than for diagnosis in these patients.

scholarly journals How accurate is frozen section pathology compared to permanent pathology in detecting involved margins and lymph nodes in breast cancer?

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zahra Mehdipour Namdar ◽  
Navid Omidifar ◽  
Peyman Arasteh ◽  
Majid Akrami ◽  
Sedigheh Tahmasebi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Predictive Value ◽  
Frozen Section ◽  
Area Under The Curve ◽  
Sentinel Lymph Nodes ◽  
Lymph Node Status ◽  
Pathology Reports ◽  
Sensitivity Specificity

Abstract Background Frozen section (FS) pathology has multiple limitations, and different institutions report variable experiences with the use of FS for diagnosis of tumor involvement. We aimed to compare the FS accuracy with that of permanent pathology (gold standard) regarding marginal involvement and lymph node status using data from the largest breast cancer registry in Iran. Methods In this retrospective study, women who had both FS and permanent pathology reports were included. The two pathology reports were cross compared with regard to the involvement of tumor margins and sentinel lymph nodes. Results Overall, 2786 patients entered the study. Mean age of patients was 48.96±11.44 years. A total of 1742 margins were analyzed. Accordingly, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FS pathology for detection of involvement of involved margins were 78.49%, 97.63%, 65.1%, and 98.7%, respectively. The accuracy and area under the curve (AUC) for FS pathology were 96.61% and 0.73 (95% CI: 0.64–0.831), respectively. A total of 1702 sentinel lymph node biopsies were assessed. Sensitivity, specificity, PPV, and NPV, of FS pathology for detection of lymph node involvement, were 87.1%, 98%, 95.5%, and 93.3%, respectively. Accuracy and AUC of FS for diagnosis of involved lymph nodes were 94.1% and 0.926 (95% CI: 0.909–0.942), respectively. Conclusion Frozen pathology is a suitable method for identifying involved sentinel lymph nodes in patients with breast cancer, but this method has a less than optimum efficacy for detecting and confirming marginal involvement.

scholarly journals Comparison of Ultrasonography and Fine Needle Aspiration Cytology in the Diagnosis of Malignant Breast Lesions in a Rural Setup

2016 ◽  
Vol 02 (02) ◽  
pp. 058-065
Author(s):  
Rounak Kalwani ◽  
K Kher ◽  
Sonam Daftari
Keyword(s):  
False Negative ◽  
Needle Aspiration ◽  
True Positive ◽  
Breast Lump ◽  
Aspiration Cytology ◽  
True Negative ◽  
Predictive Values ◽  
Malignant Breast ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Abstract Introduction: Breast cancer is the most common cancer diagnosed in women worldwide. These rising trends have emphasized the need of prompt detection, effective clinical evaluation, and exact diagnosis of the breast disease. Aim: To analyze and compare the sensitivity, specificity, and predictive values and accuracy of ultrasonography (USG) and fine needle aspiration cytology (FNAC) in diagnosing malignant breast lump. Materials and methods: A cross-sectional, prospective study was done. One hundred sixteen female patients attending surgery department with breast lump were included. After complete clinical evaluation of the lump, all patients underwent USG and FNAC examination for diagnosis of the lump, and further subjected to excisional biopsy/definitive surgery, the results of which were further compared with the histopathological results to determine the accuracy, sensitivity, specificity, and predictive values of FNAC and USG. Results: Out of 116, 61 (52.58%) benign lesions were found while the remaining 55 (47.41%) resulted to be malignant lesions on histopathological examination (HPE). Ultrasonography reported 46 true positive, 60 true negative, and 4 false negative cases with 6 inconclusive reports; whereas, FNAC reported 47 true positive, 61 true negative, and 6 false negative cases with 2 inconclusive reports. There were no false positive cases detected by USG and FNAC. Thus, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for USG was found to be 92, 100, 100, 93.75, and 96.36% (χ2-value = 94.88, p-value = 0.0001,S) and values of 88.68, 100, 100, 91.04, and 94.73% were obtained for FNAC respectively (χ2-value = 92.04, p = 0.0001,S). Conclusion: In diagnosing malignant breast lesion, USG and FNAC are 100% specific. Although USG appears more sensitive than FNAC, the percentage of indeterminate report is higher with USG.

The role of serum periostin in the diagnosis of asthma: A meta-analysis

2020 ◽  
Vol 41 (4) ◽  
pp. 240-247
Author(s):  
Lei Yang ◽  
Qingtao Zhao ◽  
Shuyu Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Negative Results ◽  
Noninvasive Biomarker ◽  
Sensitivity Specificity ◽  
Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

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