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One-step nucleic acid amplification (OSNA) for the detection of sentinel lymph node metastasis in endometrial cancer

  • Author Footnotes
    1 These authors contributed equally to this work.
    María E. López-Ruiz
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Department of Pathology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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  • Author Footnotes
    1 These authors contributed equally to this work.
    María D. Diestro
    Footnotes
    1 These authors contributed equally to this work.
    Affiliations
    Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

    Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain

    Gynecologic Oncology Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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  • Laura Yébenes
    Affiliations
    Department of Pathology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

    Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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  • Alberto Berjón
    Affiliations
    Department of Pathology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

    Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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  • Begoña Díaz de la Noval
    Affiliations
    Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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  • Marta Mendiola
    Affiliations
    Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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  • Javier De Santiago
    Affiliations
    Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

    Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain

    Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
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  • David Hardisson
    Correspondence
    Corresponding author at: Department of Pathology; Hospital Universitario La Paz, IdiPAZ, Paseo de la Castellana, 261, 28046 Madrid, Spain.
    Affiliations
    Department of Pathology, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain

    Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain

    Molecular Pathology and Therapeutic Targets Group, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
Published:August 03, 2016DOI:https://doi.org/10.1016/j.ygyno.2016.07.106

      Highlights

      • 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.

      Abstract

      Objective

      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.

      Methods

      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.

      Results

      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.

      Conclusion

      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.

      Keywords

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