PD47-01 DETECTION OF CYTOKERATIN 19 EXPRESSION USING ONE-STEP NUCLEIC ACID AMPLIFICATION (OSNA): A NEW MOLECULAR METHOD FOR LYMPH NODE STAGING IN PROSTATE CANCER?

Introduction: Approximately 20% - 30% of histological lymph node-negative patients with colorectal cancer relapse at five years after surgical treatment. This recurrence is likely due to occult nodal disease undetected by standard histopathological practice which has implications in terms of the clinical management of patients.Material and Methods: Lymph nodes were collected from colectomy specimens. A central section from each lymph node was histologically examined following haematoxylin-eosin staining and the remaining tissue was subjected to OSNA - one step nucleic acid amplification analysis.Results: A total of 1046 lymph nodes from 59 pN0 patients were assessed. Of these, 753 lymph nodes were examined by both methods. The median number of lymph nodes assessed with OSNA - one step nucleic acid amplification was 12 (IQR: 7;16). Among pN0 patients, 17 had OSNA - one step nucleic acid amplification-positive lymph nodes, resulting in a positive molecular staging rate of 28.8% (95% CI: 17.8 - 42.1). Among these patients, 12 (70.59%) were molecular-staged as pN1 and 5 (29.41%) were molecular staged as pN2. The tumour burden of lymph nodes assessed with OSNA - one step nucleic acid amplification ranged from 270 to 17 000 cytokeratin 19 mRNA copies/μL. Most of these patients (88.2%) were found to have lymph nodes with micrometastases only (250 - 4999 copies/μL).Discussion: We provide the results from the first study of the use of the OSNA - one step nucleic acid amplification assay in colorectal cancer patients in Portugal. Our results are in-line with other international studies, showing the improvement on patients’ staging by molecular examination of lymph nodes.Conclusion: In our study, 28.8% of patients with histologically negative lymph nodes were found to have metastatic lymph nodes using OSNA - one step nucleic acid molecular assessment. OSNA - one step nucleic acid assay allows a more accurate staging of patients with colorectal cancer and standardizes lymph node assessment.

Download Full-text

Cytokeratin 19 expression in early oral squamous cell carcinoma and their metastasis: Inadequate biomarker for one-step nucleic acid amplification implementation in sentinel lymph node biopsy procedure

Head & Neck ◽

10.1002/hed.24847 ◽

2017 ◽

Vol 39 (9) ◽

pp. 1864-1868 ◽

Cited By ~ 6

Author(s):

Rob Noorlag ◽

Robert J. J. van Es ◽

Remco de Bree ◽

Stefan M. Willems

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Nucleic Acid ◽

Sentinel Lymph Node ◽

Sentinel Lymph Node Biopsy ◽

Lymph Node Biopsy ◽

Nucleic Acid Amplification ◽

Cytokeratin 19 ◽

Node Biopsy ◽

One Step

Download Full-text

One Step Nucleic Acid Amplification (OSNA) - a new method for lymph node staging in colorectal carcinomas

Journal of Translational Medicine ◽

10.1186/1479-5876-8-83 ◽

2010 ◽

Vol 8 (1) ◽

Cited By ~ 25

Author(s):

Roland S Croner ◽

Vera Schellerer ◽

Helene Demund ◽

Claus Schildberg ◽

Thomas Papadopulos ◽

...

Keyword(s):

Lymph Node ◽

Nucleic Acid ◽

Nucleic Acid Amplification ◽

New Method ◽

Lymph Node Staging ◽

Colorectal Carcinomas ◽

One Step

Download Full-text

Molecular Lymph Node Staging with One-Step Nucleic Acid Amplification and its Prognostic Value for Patients with Colon Cancer: The First Follow-up Study

World Journal of Surgery ◽

10.1007/s00268-020-05949-6 ◽

2021 ◽

Author(s):

Benjamin Weixler ◽

Sofia Teixeira da Cunha ◽

René Warschkow ◽

Nicolas Demartines ◽

Ulrich Güller ◽

...

Keyword(s):

Colon Cancer ◽

Lymph Node ◽

Nucleic Acid ◽

Prognostic Value ◽

Diagnostic Value ◽

Nucleic Acid Amplification ◽

Lymph Node Staging ◽

Cancer Specific Survival ◽

One Step

Abstract Background Molecular lymph node workup with one-step nucleic acid amplification (OSNA) is a validated diagnostic adjunct in breast cancer and also appealing for colon cancer (CC) staging. This study, for the first time, evaluates the prognostic value of OSNA in CC. Patients and methods The retrospective study includes patients with stage I-III CC from three centres. Lymph nodes were investigated with haematoxylin and eosin (H&E) and with OSNA, applying a 250 copies/μL threshold of CK19 mRNA. Diagnostic value of H&E and OSNA was assessed by survival analysis, sensitivity, specificity and time-dependent receiver operating characteristic curves. Results Eighty-seven patients were included [mean follow-up 53.4 months (± 24.9)]. Disease recurrence occurred in 16.1% after 19.8 months (± 12.3). Staging with H&E independently predicted worse cancer-specific survival in multivariate analysis (HR = 10.77, 95% CI 1.07–108.7, p = 0.019) but not OSNA (HR = 3.08, 95% CI 0.26–36.07, p = 0.197). With cancer-specific death or recurrence as gold standard, H&E sensitivity was 46.7% (95% CI 21.3–73.4%) and specificity 84.7% (95% CI 74.3–92.1%). OSNA sensitivity and specificity were 60.0% (95% CI 32.3–83.7%) and 75.0% (95% CI 63.4–84.5%), respectively. Conclusions In patients with CC, OSNA does not add relevant prognostic value to conventional H&E contrasting findings in other cancers. Further studies should assess lower thresholds for OSNA (< 250 copies/μL).

Download Full-text

Evaluation of Fast Molecular Detection of Lymph Node Metastases in Prostate Cancer Patients Using One-Step Nucleic Acid Amplification (OSNA)

Cancers ◽

10.3390/cancers13051117 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1117

Author(s):

Svenja Engels ◽

Lutz Brautmeier ◽

Lena Reinhardt ◽

Clara Wasylow ◽

Friederike Hasselmann ◽

...

Keyword(s):

Prostate Cancer ◽

Nucleic Acid ◽

Sensitivity And Specificity ◽

Nucleic Acid Amplification ◽

Cytokeratin 19 ◽

High Concordance ◽

One Step ◽

Node Metastases ◽

Positive Results ◽

Level Of Agreement

Background: In clinical routine, only fractions of lymph nodes (LNs) are examined histopathologically, often resulting in missed (micro-)metastases and incorrect staging of prostate cancer (PCa). One-step nucleic acid amplification (OSNA) analyzes the entire LN by detecting cytokeratin 19 (CK19) mRNA as a surrogate for LN metastases requiring less effort than conventional biomolecular techniques. We aimed to evaluate performance of OSNA in detecting sentinel LN (SLN) metastases in PCa. Methods: SLNs (n = 534) of 64 intermediate- or high-risk PCa patients undergoing radical prostatectomy with extended and sentinel-guided lymphadenectomy were cut into slices and alternatingly assigned to OSNA and histopathology (hematoxylin-eosin staining, CK19, and CK AE1/AE3 immunohistochemistry). Sensitivity and specificity of OSNA and concordance and measure of agreement (Cohen’s kappa (κ)) between OSNA and histopathology were assessed. Results: Histopathology revealed metastases in 76 SLNs. Sensitivity and specificity of OSNA were 84.2% and 96.1%, respectively. Discordant results were recorded for 30 of 534 SLNs, revealing high concordance (94.4%). Twenty-four discordant cases were classified as micrometastases, indicating a possible allocation bias. In 18 cases, positive results were conferred only by OSNA resulting in seven LN-positive patients who were missed by histopathology. Overall, the level of agreement was high (κ = 0.78). Conclusions: OSNA provided a diagnosis that was as least as accurate as detailed histological examination and might improve LN staging in PCa.

Download Full-text