Questions and answers


What are Cytonel Plus and Cytonel-19 kits?

Cytonel Plus and Cytonel-19 kits are qualitative in vitro diagnostic test for intraoperative detection of metastases in sentinel lymph node biopsies of breast cancer patients.


What is the difference between Cytonel-Plus and Cytonel-19?

Cytonel-Plus consists of a cocktail of monoclonal pancytokeratin antibodies, which detect epithelial (carcinoma) cells expressing cytokeratins 4,5,6,7,8,10,13,18 and 19. Cytonel-19 is comprised of two monoclonal antibodies which are specific to cytokeratin 19.


How does it work?

Cytonel Plus and Cytonel-19 kits detect the spread of breast cancer cells to lymph nodes immunohistochemically. Frozen tissue sections of the sentinel node are incubated with an anti-pancytokeratin (Cytonel-Plus) or cytokeratin 19 (Cytonel-19) antibodies which are labelled with horseradish peroxidase. Peroxidase enzyme is detected by using diaminobenzide as chromogenic substrate. The staining result is inspected with a light microscope. If breast cancer cells (metastases) are present in the lymph nodes, peroxidase-positive (darkly brown-stained) cells can be seen under light microscope. Absence of positively stained cells means that metastases are not present in the stained tissue sections.


When is the kit used?

During surgery to remove breast tumor, patient often undergoes biopsy of the sentinel (i.e., first) node(s) that receive lymphatic fluid from the breast. The lymph nodes are examined by a pathologist. Cytonel Ultrarapid IHC kits are used together with routine stain (hematoxylin & eosin or toluidine blue) and to aid in the identification metastatic carcinoma cells. If metastases are found, additional lymph nodes might need to be removed. Follow-up examination of remaining sentinel lymph node tissue under a microscope is required.


What will it accomplish?

Results from the Cytonel Ultrarapid IHC kits can help the pathologist to define the presence or absence of metastasis in the lymph node. This information is used by the surgeon in deciding whether to remove additional axillary lymph nodes. The Cytonel Ultrarapid IHC kits are currently not thoroughly tested for tissues other than sentinel lymph nodes from breast cancer patients. Additional information: Cytonel Ultrarapid IHC tests may be used with sentinel lymph node biopsy for patients who have been informed about the risks, benefits and limitations of this test. True positive results may prompt the removal of additional lymph nodes during initial surgery. False negative or inconclusive test results may delay the needed removal of additional lymph nodes. (see