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A mathematical approach to the optimal examination of lymph nodes

Authors
 CHI YOUNG AHN  ;  SE HOON KIM  ;  SEON JUNG JANG  ;  SOON WON HONG  ;  HYUNKI KIM  ;  BEOM JIN LIM 
Citation
 APMIS, Vol.119(12) : 868-876, 2011 
Journal Title
APMIS
ISSN
 0903-4641 
Issue Date
2011
MeSH
Humans ; Lymph Node Excision/methods* ; Models, Theoretical ; Probability ; Sentinel Lymph Node Biopsy*
Keywords
Sentinel lymph node biopsy ; frozen sections ; metastasis
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)
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1600-0463.2011.02795.x/abstract
DOI
10.1111/j.1600-0463.2011.02795.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Hyunki(김현기) ORCID logo https://orcid.org/0000-0003-2292-5584
Lim, Beom Jin(임범진) ORCID logo https://orcid.org/0000-0003-2856-0133
Hong, Soon Won(홍순원) ORCID logo https://orcid.org/0000-0002-0324-2414
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/94678
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