{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T01:52:10Z","timestamp":1783734730610,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2010,2,9]],"date-time":"2010-02-09T00:00:00Z","timestamp":1265673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2010,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background.<\/jats:title><jats:p>The objective of this study was to determine the relative efficacy of different methods of pathologic evaluation of sentinel lymph nodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>In this prospective study, sentinel nodes were evaluated for occult metastasis using frozen section, imprint\u2010cytology, hematoxylin\u2010eosin staining, serial step sectioning (SSS) with hematoxylin\u2010eosin, and immunohistochemistry (IHC). Metastases were classified into macrometastasis (&gt;2.0 mm), micrometastasis (0.2 mm\u20132.0 mm), isolated tumor cells (&lt;0.2 mm).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Occult metastasis was detected in 20 of 80 patients. Frozen section and imprint cytology identified metastasis in 10 of 20 patients, hematoxylin\u2010eosin stain in 13 patients; SSS upstaged the disease in a further 7 patients (9%). Frozen section detected macrometastasis in 7 of 8 cases but failed to detect smaller metastases (missed micrometastasis in 4 of 7 and isolated tumor cells in 5 of 5). SSS upstaged the disease by 10%, and sensitivity and negative predictive value of SSS with hematoxylin\u2010eosin stain were 90% and 97%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Frozen section and imprint cytology are not effective in identifying occult metastasis. IHC and SSS are required to identify micrometastasis and isolated tumor cells. \u00a9 2010 Wiley Periodicals, Inc. 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