- •We examined the utility of the OSNA method in the detection of metastases in SLNs in EC.
- •The OSNA assay shows high sensitivity and specificity in detecting SLN metastases in EC.
- •The OSNA assay is a novel tool for the molecular detection of SLN metastasis in patients with EC.
- •These results should be validated in a larger series of patients.
To evaluate the efficacy of one-step nucleic acid amplification (OSNA) for the diagnosis of sentinel lymph node (SLN) metastasis compared with histopathological examination in patients with endometrial carcinoma.
A total of 94 SLNs from 34 patients with endometrial carcinoma were enrolled. The central 1-mm portion of each node was subjected to semi-serial sectioning, sliced at 200-μm intervals and examined by hematoxylin and eosin and cytokeratin 19 (CK19) immunohistochemical staining, and the remaining tissue was analysed by OSNA using CK19 mRNA. The accuracy of the OSNA assay was evaluated based on histopathological diagnosis.
Histologically, 89 SLNs were determined to be metastasis negative, and the remaining five SLNs were metastasis positive. Using the breast cancer cutoff value for detecting lymph node metastasis (OSNA criteria for breast cancer, >250 copies/μl) the sensitivity of the OSNA assay was 100%; specificity was 87.6%; diagnostic accuracy was 88.3%. Discordant results were recorded for 11 of 94 SLNs. In all 11 cases, a positive result was given by the OSNA assay but not by histopathological examination. In two SLNs from the same patient, histopathological examination revealed the presence of benign epithelial inclusions that were CK19 positive; both SLNs yielded a positive result in the OSNA assay (true–false positive). All remaining nine histologically-negative/OSNA-positive SLNs were classified as micrometastasis (+) by the OSNA assay.
The OSNA assay shows high sensitivity and specificity, which suggests its utility as a novel tool for the molecular detection of SLN metastasis in patients with endometrial carcinoma.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Gynecologic Oncology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Sentinel node biopsy for the management of early stage endometrial cancer: long-term results of the SENTI-ENDO study.Gynecol. Oncol. 2015; 136: 54-59https://doi.org/10.1016/j.ygyno.2014.09.011
- Sentinel lymph node mapping in endometrial cancer: an update.Oncologist. 2016; : 461-466https://doi.org/10.1634/theoncologist.2015-0473
- Sentinel lymph node evaluation in endometrial cancer and the importance of micrometastases.Surg. Oncol. 2008; 17: 237-245https://doi.org/10.1016/j.suronc.2008.04.001
- Immunohistochemical workup of sentinel nodes in endometrial cancer improves diagnostic accuracy.Gynecol. Oncol. 2009; 114: 284-287https://doi.org/10.1016/j.ygyno.2009.04.020
- Comparison of diagnostic accuracy of frozen section with imprint cytology for intraoperative examination of sentinel lymph node in early-stage endometrial cancer: results of Senti-Endo study.Ann. Surg. Oncol. 2012; 19: 3515-3521https://doi.org/10.1245/s10434-012-2390-7
- One-step nucleic acid amplification for intraoperative detection of lymph node metastasis in breast cancer patients.Clin. Cancer Res. 2007; 13: 4807-4816https://doi.org/10.1158/1078-0432.CCR-06-2512
- Cytokeratin 19 expression in normal endometrium and in low-grade endometrioid adenocarcinoma of the endometrium.Int. J. Gynecol. Pathol. 2011; 30: 484-491https://doi.org/10.1097/PGP.0b013e3182158944
- A new diagnostic method for rapid detection of lymph node metastases using a one-step nucleic acid amplification (OSNA) assay in endometrial cancer.Ann. Surg. Oncol. 2015; 22: 980-986https://doi.org/10.1245/s10434-014-4038-2
- WHO Classification of Tumours of Female Reproductive Organs.fourth ed. IARC, Lyon2014
- AJCC Cancer Staging Manual.seventh ed. Springer, New York2010
- Atlas of Lymph Node Pathology.Springer New York, New York, NY2013https://doi.org/10.1007/978-1-4614-7959-8
- Glandular inclusions in pelvic and abdominal para-aortic lymph nodes. A study of autopsy and surgical material in males and females.Am. J. Clin. Pathol. 1969; 52: 212-218
- Glandular inclusions in lymph nodes. The problem of extensive involvement and relationship to salpingitis.Am. J. Surg. Pathol. 1981; 5: 353-359
- Frequency and histogenesis of pelvic retroperitoneal lymph node inclusions of the female genital tract. An immunohistochemical study of 34 cases.Pathol. Res. Pract. 1995; 191: 991-996
- Benign glandular inclusions.Hum. Pathol. 1986; 17: 100-101
- Benign glandular inclusions in para-aortic lymph nodes in women undergoing lymphadenectomies.Am. J. Obstet. Gynecol. 1978; 130: 813-816
- Absence of ectopic epithelial inclusions in 3,904 axillary lymph nodes examined in sentinel technique.Breast Cancer Res. Treat. 2012; 132: 621-624https://doi.org/10.1007/s10549-011-1923-2
- Ectopic breast tissue as a possible cause of false-positive axillary sentinel lymph node biopsies.Am. J. Surg. Pathol. 2003; 27: 513-518
- Do uterine risk factors or lymph node metastasis more significantly affect recurrence in patients with endometrioid adenocarcinoma?.Gynecol. Oncol. 2012; 125: 94-98https://doi.org/10.1016/j.ygyno.2011.11.049
- Lymph node metastasis and pattern of recurrence in clinically early stage endometrial cancer with positive lymphovascular space invasion.J. Gynecol. Oncol. 2015; 26: 208-213https://doi.org/10.3802/jgo.2015.26.3.208
Published online: August 03, 2016
Accepted: July 19, 2016
Received in revised form: July 14, 2016
Received: May 4, 2016
☆Presented in part at the 27th Congress of the European Society of Pathology, Belgrade, 5–9 September 2015 (Abstract # OFP-06-004).
© 2016 Elsevier Inc. All rights reserved.