Immunohistological detection of lymph node XXXX in the testicular center as quick section diagnosis during retroperitoneal lymphadenectomy.

@entity1 @entity5 @entity3
The object of this study was to determine whether the immunohistochemical detection of cytokeratin (CK)-positive cells is useful as quick section diagnosis, and whether the retroperitoneal lymphadenectomy (RLA) can be reduced by this method without any disadvantage for the @entity1 . The RLA represents a combined diagnostic and therapeutic procedure for staging as well as removal of regional lymph node @entity3 in @entity1 with @entity5 . The disadvantage of the radical RLA is a 40 to 90% loss of potency. The risk of the reduced RLA is the relapse. The metastatic affection of the first retroperitoneal lymph node station, the so-called "sentinale" lymph nodes, allows a judgement for the remaining lymph nodes, and, therefore, for the extent of the necessary operation. The conventional frozen technique has a limited reliability, whereas the paraffin technique needs too much time. We used the immunohistochemistry as alternative method for the rapid as well as reliable evaluation of @entity3 . A group (7 cases) of 35 @entity1 with @entity5 of the testis was only treated by radical RLA after detection of CK-positive cells in the sentinale lymph nodes. The other @entity1 were treated by modified RLA (20 cases) or reduced RLA (6 cases). The results were compared with a control group (48 cases) which was treated by radical RLA only. Using the modified RLA the relapse-free interval was not affected and the loss of ejaculation as a consequence of radical treatment could be avoided.(ABSTRACT TRUNCATED AT 250 WORDS)
