The Diagnostic Accuracy of One-Step Nucleic Acid Amplification for Lymph Node Metastases of Papillary Thyroid Carcinoma： A Systematic Review and Meta-Analysis

BackgroundOne-step nucleic acid amplification (OSNA) analysis is a molecular diagnostic technique for lymph node metastases (LNMs) by quantifying cytokeratin 19(CK 19) mRNA. We aim to evaluate the intraoperative diagnostic accuracy of OSNA assay for LNMs of papillary thyroid carcinoma (PTC).MethodsPubMed, Embase, Cochrane Library, and Web of Science databases were searched to retrieve related literature. A meta-analysis was performed using STATA11.0, Meta-Disc 1.4 and RevMan 5.3.ResultsThis meta-analysis included six studies involving 987 lymph nodes from 194 patients. The pooled sensitivity, specificity, and area under the summary receiver-operating characteristic curve (AUC) of OSNA for detecting LNM were 0.88, 0.90, and 0.95, respectively.ConclusionOSNA assay is an accurate molecular diagnosis for intraoperative detection of lymph node metastasis in PTC.

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Evaluation of Accuracy of One-Step Nucleic Acid Amplification (OSNA) in Diagnosis of Lymph Node Metastases of Papillary Thyroid Carcinoma

Case Medical Research ◽

10.31525/ct1-nct03889769 ◽

2019 ◽

Author(s):

Keyword(s):

Lymph Node ◽

Nucleic Acid ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Lymph Node Metastases ◽

Nucleic Acid Amplification ◽

Papillary Thyroid ◽

One Step ◽

Node Metastases

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Evaluation of accuracy of one-step nucleic acid amplification (OSNA) in diagnosis of lymph node metastases of papillary thyroid carcinoma. Diagnostic study

Annals of Medicine and Surgery ◽

10.1016/j.amsu.2019.08.006 ◽

2019 ◽

Vol 46 ◽

pp. 17-22 ◽

Cited By ~ 4

Author(s):

Fabio Medas ◽

Pierpaolo Coni ◽

Francesco Podda ◽

Claudia Salaris ◽

Federico Cappellacci ◽

...

Keyword(s):

Lymph Node ◽

Nucleic Acid ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Lymph Node Metastases ◽

Nucleic Acid Amplification ◽

Diagnostic Study ◽

Papillary Thyroid ◽

One Step ◽

Node Metastases

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Evaluation of accuracy of One Step Nucleic acid Amplification (OSNA) in diagnosis of lymph node metastases of papillary thyroid carcinoma: a comparison between real-time PCR and histopatology

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2020.06.070 ◽

2020 ◽

Vol 46 (12) ◽

pp. e7

Author(s):

J. Marcialis ◽

F. Medas ◽

F. Podda ◽

F. Cappellacci ◽

M.L. Lai ◽

...

Keyword(s):

Lymph Node ◽

Nucleic Acid ◽

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Lymph Node Metastases ◽

Real Time Pcr ◽

Nucleic Acid Amplification ◽

Papillary Thyroid ◽

One Step ◽

Node Metastases

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One-step nucleic acid amplification for intraoperative analysis of sentinel lymph node in papillary thyroid carcinoma

Acta Endocrinologica ◽

10.1530/eje-18-0624 ◽

2019 ◽

Vol 180 (1) ◽

pp. 21-29 ◽

Cited By ~ 3

Author(s):

Carmela Iglesias Felip ◽

Carles Zafon Llopis ◽

Jordi Temprana-Salvador ◽

Amparo García-Burillo ◽

Xavier Serres Créixams ◽

...

Keyword(s):

Lymph Node ◽

Nucleic Acid ◽

Papillary Thyroid Carcinoma ◽

Sentinel Lymph Node ◽

Thyroid Carcinoma ◽

False Negative ◽

Lymph Node Biopsy ◽

Nucleic Acid Amplification ◽

Papillary Thyroid ◽

One Step

Objective Lymphadenectomy in papillary thyroid carcinoma (PTC) is controversial. It is indicated whenever metastases have been proven before or during surgery and as a prophylactic treatment in high-risk patients. However, 30–50% of cN0 patients become pN1 postoperatively. In PTC, selective-sentinel-lymph-node-biopsy (SLNB) with conventional intraoperative analysis is 8% false negative. One-step nucleic acid amplification (OSNA) is a molecular technique which allows real-time detection of mRNA encoding for cytokeratin 19. OSNA has been introduced in intraoperative analysis of several tumors to reduce false-negative rates and distinguish micrometastasis from macrometastasis. Our objective was to evaluate the impact of the introduction of OSNA in the intraoperative evaluation of the sentinel node (SN) in PTC. Design We analyzed a series of 35 patients subjected to SLNB. Methods All the dissected nodes, SN and non-SN, were evaluated with OSNA and cytology. Results We obtained a total of 110 SN. SLNB proved positive in 14 patients (40%) with cytology and in 23 (65.7%) with OSNA (P < 0.001). In the 29 patients with subsequent lymphadenectomy we obtained 360 lymph nodes ((52 positive in cytology (14.4%) and 107 in OSNA (29.7%)). Lymphadenectomy proved positive in 16 patients according to cytology (55%) and in 24 according to OSNA (83%) (P = 0002). The majority of patients with micrometastasis in SN showed only micrometastasis in lymphadenectomy. Conclusions The present study shows selective-sentinel-lymph-node-biopsy with one-step nucleic acid amplification technique to be feasible in papillary thyroid carcinoma. The quantitative nature of one-step nucleic acid amplification paves the way toward a more personalized surgical approach, limiting lymphadenectomy to patients with intraoperative evidence of macrometastasis in the sentinel node.

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