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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Article info
Publication history
Published online: August 03, 2016
Accepted:
July 19,
2016
Received in revised form:
July 14,
2016
Received:
May 4,
2016
Footnotes
☆Presented in part at the 27th Congress of the European Society of Pathology, Belgrade, 5–9 September 2015 (Abstract # OFP-06-004).
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
