Analysis of clinicopathologic features of false negative sentinel lymph nodes in patients with endometrial cancer / 国际肿瘤学杂志

Objective:To compare the clinicopathological features of patients with false negative and true negative pathological biopsy of sentinel lymph nodes in endometrial cancer, and to explore the related factors of missed diagnosis of sentinel lymph nodes.Methods:From January 2020 to January 2022, 31 patients underwent sentinel lymph node biopsy combined with systematic lymph node resection in the First Affiliated Hospital of Shandong First Medical University were retrospectively analyzed, of which 2 were false negative and 29 were true negative. PubMed literature on sentinel lymph node false negative of endometrial cancer was searched from the establishment of the database to December 2022, with the search terms "Sentinel lymph node" "Endometrial neoplasms" and "False negative" . A total of 15 cases of false negative patients with similar methods to this study were extracted. In the false negative group, there were 17 false negative patients with sentinel lymph node negative but systemically excised lymph node positive, including 2 cases in our hospital and 15 cases in the literature. The true negative group included 29 true negative patients with negative sentinel and systemic lymph nodes, all from our hospital. The clinicopathologic features of the two groups were compared.Results:There were statistically significant differences in tumor grade ( χ2=6.09, P=0.014) , lymph vascular space invasion ( P=0.012) and myometrial invasion ( χ2=9.66, P=0.002) between the two groups. However, there was no significant difference in histological type between the two groups ( χ2=0.19, P=0.661) . Conclusion:There is a risk of false negative for sentinel lymph node biopsy in patients with endometrial carcinoma with high-grade tumor, myometrial invasion ≥1/2 and lymph vascular space invasion.

False-negative result of serum cryptococcal antigen lateral flow assay in an HIV-infected patient with culture-proven cryptococcaemia

The detection of cryptococcal capsular antigen (CrAg) is very sensitive and specific, however false-negative results have been reported, mostly in cerebrospinal fluid. We report the case of an HIV-infected patient with CD4=42 cells/mL, asthenic, negative serum CrAg lateral flow assay (LFA) and culture-proven cryptococcaemia. Despite the high accuracy of LFA, false-negative result is possible. Careful clinical evaluation and close follow-up are relevant

False-negative result of serum cryptococcal antigen lateral flow assay in an HIV-infected patient with culture-proven cryptococcaemia.

The detection of cryptococcal capsular antigen (CrAg) is very sensitive and specific, however false-negative results have been reported, mostly in cerebrospinal fluid. We report the case of an HIV-infected patient with CD4 = 42 cells/mL, asthenic, negative serum CrAg lateral flow assay (LFA) and culture-proven cryptococcaemia. Despite the high accuracy of LFA, false-negative result is possible. Careful clinical evaluation and close follow-up are relevant.

Sensitivity of high-resolution ultrasonography in clinically diagnosed carpal tunnel syndrome patients with hand pain and normal nerve conduction studies.

BACKGROUND: Suspecting carpal tunnel syndrome (CTS) in patients with hand pain is usual. Considering the variable rate of false-negative results in nerve conduction study (NCS), as a frequent reference confirmatory standard test, we aimed to evaluate the diagnostic accuracy of neuromuscular ultrasound in patients with clinical evidence of CTS and normal NCS. METHODS: It was a diagnostic accuracy study conducted in the outpatient clinic of Rofaydeh Hospital, Tehran, Iran, between July 2012 and December 2016; it recruited clinically diagnosed CTS patients and a control group. All participants underwent comprehensive clinical examination, NCS, and high-resolution ultrasonography of the median nerve. RESULTS: Two hundred and fifty patients with clinical evidence of CTS met the inclusion criteria, of whom 103 (27.1%) had normal NCS and underwent an ultrasound examination. A cutoff point of 9.4 mm2 (mean + 2 standard deviation) for median nerve cross-sectional area at the carpal tunnel inlet from the control group was set to detect 73% abnormality in the case group. CONCLUSION: Ultrasonography had a sensitivity rate of 73% in patients with clinical CTS and negative NCS, increasing the overall diagnostic sensitivity for clinically suspected CTS in the electrodiagnostic lab setting to 92%. The study highlights the complementary role of ultraso-nography in diagnosing CTS in conjunction with NCS.

False-negative Frozen Section of Sentinel Lymph Node Biopsy in a Chinese Population with Breast Cancer.

AIM: This study aimed to investigate the accuracy of frozen section (FS) in diagnosis of sentinel lymph node metastasis and to analyze the predictive factors for false-negativity. PATIENTS AND METHODS: Patients with breast cancer and clinically negative axillary were recruited for sentinel lymph node biopsy (SLNB). All nodes were examined by intraoperative FS and underwent further paraffin sectioning. RESULTS: A total of 1,272 patients underwent SLNB over an 8-year period, and 53 patients had false-negative FS. Univariate and multivariate analysis revealed that younger age, stellate mammographic pattern, and ER-positive status were statistically different when compared to the 53 members of the cohort who were truly negative on SLNB (control group). Eight patients were lost to clinical follow-up; the recurrence-free survival rate of the remaining 49 patients with false-negative SLNB did not differ from that of the 49-patient cohort (control group) (p=0.072), while these patients did experience poorer overall survival (p=0.035). CONCLUSION: Younger age, stellate mammographic pattern and ER-positive status were independent predictors for false-negative FS on biopsy.

Investigation on Causes of False-negative 14 C-Urea Breath Test / 胃肠病学

Background:14 C-urea breath test(14 C-UBT)is widely used for diagnosis of Helicobacter pylori(Hp)infection owing to its noninvasiveness and high sensitivity and specificity. Nevertheless,the presence of false-negative result can influence the diagnostic accuracy. Aims:To investigate the possible causes of false-negative 14 C-UBT for improving the accuracy of diagnosis. Methods:Eight-two cases with confirmed false-negative 14 C-UBT and 813 controls with true-positive 14 C-UBT at the People’s Hospital of Xinjiang Uygur Autonomous Region from Jan. 2014 to Aug. 2014 were enrolled. Patients in both groups were diagnosed as positive for Hp infection by Warthin-Starry silver staining combined with Hp stool antigen test. Univariate and multivariate analysis were performed to screen the factors related with false-negative 14 C-UBT. Results:In univariate analysis,5 variables were significantly different between case group and control group(P ﹤ 0. 05),and were taken into the multivariate analysis. Logistic stepwise regression analysis revealed that bile reflux( OR = 3. 961,P ﹤0. 001),post subtotal gastrectomy(OR = 9. 734,P ﹤ 0. 001),type Ⅱ Hp infection(OR = 1. 892,P = 0. 012)and upper gastrointestinal bleeding( OR = 4. 979,P ﹤ 0. 001 ) were the independent risk factors for false-negative 14 C-UBT. Conclusions:Bile reflux,upper gastrointestinal bleeding,post subtotal gastrectomy and type Ⅱ Hp infection might be the influential factors for false-negative 14 C-UBT. Combined tests for Hp infection should be suggested in patients with negative 14 C-UBT who had undergone subtotal gastrectomy or complicated with bile reflux or upper gastrointestinal bleeding.