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A mathematical approach to the optimal examination of lymph nodes

Authors
 CHI YOUNG AHN  ;  SE HOON KIM  ;  BEOM JIN LIM  ;  HYUNKI KIM  ;  SOON WON HONG  ;  SEON JUNG JANG 
Citation
 APMIS, Vol.119(12) : 868-876, 2011 
Journal Title
 APMIS 
ISSN
 0903-4641 
Issue Date
2011
Abstract
There is no scientific evidence to support the idea that serial sectioning along the short axis of the lymph node is superior to a single bisection along the long axis. We mathematically evaluated methods of lymph node dissection and applied the result to six lymph nodes that had produced false negative results at the time of frozen examination. We simplified the geometry of a lymph node to that of a three-dimensional ellipse and compared two different cutting methods. Let A be the cross-sectional area obtained through a single bisection along the long axis, and let B be the sum of the cross-sectional areas of n fragments obtained via serial cutting along the short axis. The smallest n (n*) that makes a B larger than A can be calculated. n* = [3L + √9L² + 16S²)/4S]. ([α], the smallest integer greater than or equal to α; L, long axis; S, short axis). The probabilities of tumor detection when the node is bisected along the long axis (P(D(A)
E)) and when serially cut along the short axis (P(D(B)
E) = (n - 1){(1 + 1/n)L² - 3LT + T²}T/(L - T)³. (T, size of the tumor cell cluster). According to these formulas, three out of six lymph nodes were not examined in the most appropriate manner.
E = {(3/2)S² - 3ST + T²}T/(S - T)³. and P(D(B)
E)) are as follows. P(D(A)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94678
DOI
10.1111/j.1600-0463.2011.02795.x
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
Yonsei Authors
김세훈(Kim, Se Hoon) ; 김현기(Kim, Hyun Ki) ; 임범진(Lim, Beom Jin) ; 홍순원(Hong, Soon Won)
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Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0463.2011.02795.x/abstract
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