Abstract
The one-step nucleic acid amplification (OSNA) method is an increasingly used procedure for intraoperative analysis of sentinel lymph node (SLN) status in breast cancer patients. It measures cytokeratin19 (CK19) mRNA copy numbers in homogenized samples of SLN; CK19 has been chosen for identifying node metastasis because most breast cancers express this molecule. However, to avoid false-negative OSNA results, testing the preoperative needle core biopsy (NCB) of breast carcinomas for CK19 by immunohistochemistry (IHC) has been recommended. This procedure relies on the assumption that protein expression is strictly related to mRNA expression. We developed this study to evaluate if IHC gives similar result to the molecular assay. In a series of breast cancer patients with axillary metastasis, corresponding surgically resected tumor and metastatic lymph node specimens have been tested for CK19 protein by IHC and for CK19 mRNA by real-time PCR; furthermore, CK19 immunostaining has been performed in NCBs when available. Statistical analysis revealed that (1) the immunohistochemical evaluation of CK19 in NCB is a reliable test, reflecting protein expression in the whole tumor and in the metastatic lymph node; (2) there is no correlation between CK19 protein expression and CK19 RNA level neither within the primary breast cancer nor within the metastatic node; moreover, no correlation as well has been found between protein expression in NCB and mRNA level in metastatic lymph nodes. Thus, our results suggest that there is no evidence-based reason to stain every NCB for CK19 before performing OSNA in patients with breast cancer.
Similar content being viewed by others
References
Lyman GH, Giuliano AE, Somerfield MR, Benson AB III, Bodurka DC, Burstein HJ, Cochran AJ, Cody HS III, Edge SB, Galper S, Hayman JA, Kim TY, Perkins CL, Podoloff DA, Sivasubramaniam VH, Turner RR, Wahl R, Weaver DL, Wolff AC, Winer EP, American Society of Clinical Oncology (2005) American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol 23(30):7703–7720
Chu PG, Weiss LM (2002) Keratin expression in human tissues and neoplasms. Histopathology 40(5):403–439
Tsujimoto M, Nakabayashi K, Yoshidome K, Kaneko T, Iwase T, Akiyama F, Kato Y, Tsuda H, Ueda S, Sato K, Tamaki Y, Noguchi S, Kataoka TR, Nakajima H, Komoike Y, Inaji H, Tsugawa K, Suzuki K, Nakamura S, Daitoh M, Otomo Y, Matsuura N (2007) One-step nucleic acid amplification for intraoperative detection of lymph node metastasis in breast cancer patients. Clin Cancer Res 13(16):4807–4816
Visser M, Jiwa M, Horstman A, Brink AA, Pol RP, van Diest P, Snijders PJ, Meijer CJ (2008) Intra-operative rapid diagnostic method based on CK19 mRNA expression for the detection of lymph node metastases in breast cancer. Int J Cancer 122(11):2562–2567
Schem C, Maass N, Bauerschlag DO, Carstensen MH, Loning T, Roder C, Batic O, Jonat W, Tiemann K (2009) One-step nucleic acid amplification—a molecular method for the detection of lymph node metastases in breast cancer patients; results of the German study group. Virchows Arch 454(2):203–210
Tamaki Y, Akiyama F, Iwase T, Kaneko T, Tsuda H, Sato K, Ueda S, Mano M, Masuda N, Takeda M, Tsujimoto M, Yoshidome K, Inaji H, Nakajima H, Komoike Y, Kataoka TR, Nakamura S, Suzuki K, Tsugawa K, Wakasa K, Okino T, Kato Y, Noguchi S, Matsuura N (2009) Molecular detection of lymph node metastases in breast cancer patients: results of a multicenter trial using the one-step nucleic acid amplification assay. Clin Cancer Res 15(8):2879–2884
Snook KL, Layer GT, Jackson PA, de Vries CS, Shousha S, Sinnett HD, Nigar E, Singhal H, Chia Y, Cunnick G, Kissin MW, Group OS (2011) Multicentre evaluation of intraoperative molecular analysis of sentinel lymph nodes in breast carcinoma. Br J Surg 98(4):527–535
Feldman S, Krishnamurthy S, Gillanders W, Gittleman M, Beitsch PD, Young PR, Streck CJ, Whitworth PW, Levine EA, Boolbol S, Han LK, Hermann R, Hoon DS, Giuliano AE, Meric-Bernstam F, Group USOSNAACS (2011) A novel automated assay for the rapid identification of metastatic breast carcinoma in sentinel lymph nodes. Cancer 117(12):2599–2607
Bernet L, Cano R, Martinez M, Duenas B, Matias-Guiu X, Morell L, Palacios J, Rezola R, Robles-Frias M, Ruiz I, Velasco A, Vieites B, Sevilla F, Torro J, Medrano J, Ballester B (2011) Diagnosis of the sentinel lymph node in breast cancer: a reproducible molecular method: a multicentric Spanish study. Histopathology 58(6):863–869
Le Frere-Belda MA, Bats AS, Gillaizeau F, Poulet B, Clough KB, Nos C, Peoc’h M, Seffert P, Bouteille C, Leroux A, Guillemin F, Blanc-Fournier C, Crouet H, Arnould L, Cuisenier J, Penault-Llorca F, Gimbergues P, Jacquemier J, Houvenaeghel G, Chatellier G, Lecuru F (2012) Diagnostic performance of one-step nucleic acid amplification for intraoperative sentinel node metastasis detection in breast cancer patients. Int J Cancer 130(10):2377–2386
Cserni G (2012) Intraoperative analysis of sentinel lymph nodes in breast cancer by one-step nucleic acid amplification. J Clin Pathol 65(3):193–199
Castellano I, Macri L, Deambrogio C, Balmativola D, Bussone R, Ala A, Coluccia C, Sapino A (2012) Reliability of whole sentinel lymph node analysis by one-step nucleic acid amplification for intraoperative diagnosis of breast cancer metastases. Ann Surg 255(2):334–342
Vilardell F, Novell A, Martin J, Santacana M, Velasco A, Diez-Castro MJ, Cuevas D, Panades MJ, Gonzalez S, Llombart A, Iglesias E, Matias-Guiu X (2012) Importance of assessing CK19 immunostaining in core biopsies in patients subjected to sentinel node study by OSNA. Virchows Arch 460(6):569–575
Maier T, Guell M, Serrano L (2009) Correlation of mRNA and protein in complex biological samples. FEBS Lett 583(24):3966–3973
Gygi SP, Rochon Y, Franza BR, Aebersold R (1999) Correlation between protein and mRNA abundance in yeast. Mol Cell Biol 19(3):1720–1730
Schwanhausser B, Busse D, Li N, Dittmar G, Schuchhardt J, Wolf J, Chen W, Selbach M (2011) Global quantification of mammalian gene expression control. Nature 473(7347):337–342
de Sousa AR, Penalva LO, Marcotte EM, Vogel C (2009) Global signatures of protein and mRNA expression levels. Mol Biosyst 5(12):1512–1526
Livak KJ, Schmittgen TD (2001) Analysis of relative gene expression data using real-time quantitative PCR and the 2(−Delta Delta C(T)) method. Methods 25(4):402–408
Charafe-Jauffret E, Ginestier C, Monville F, Finetti P, Adelaide J, Cervera N, Fekairi S, Xerri L, Jacquemier J, Birnbaum D, Bertucci F (2006) Gene expression profiling of breast cell lines identifies potential new basal markers. Oncogene 25(15):2273–2284
Vegue LB, Rojo F, Hardisson D, Iturriagagoitia AC, Panades MJ, Velasco A, Bonet EL, Munoz RC, Polo L, Investigators BC-I (2012) Comparison of molecular analysis and histopathology for axillary lymph node staging in primary breast cancer: results of the B-CLOSER-I study. Diagn Mol Pathol 21(2):69–76
Tamaki Y, Sato N, Homma K, Takabatake D, Nishimura R, Tsujimoto M, Yoshidome K, Tsuda H, Kinoshita T, Kato H, Taniyama K, Kamio T, Nakamura S, Akiyama F, Noguchi S, Japanese One-Step Nucleic Acid Amplification Study Group (2012) Routine clinical use of the one-step nucleic acid amplification assay for detection of sentinel lymph node metastases in breast cancer patients: results of a multicenter study in Japan. Cancer 118(14):3477–3483
Alvarenga CA, Paravidino PI, Alvarenga M, Dufloth R, Gomes M, Zeferino LC, Schmitt F (2011) Expression of CK19 in invasive breast carcinomas of special histological types: implications for the use of one-step nucleic acid amplification. J Clin Pathol 64(6):493–497
Parikh RR, Yang Q, Higgins SA, Haffty BG (2008) Outcomes in young women with breast cancer of triple-negative phenotype: the prognostic significance of CK19 expression. Int J Radiat Oncol Biol Phys 70(1):35–42
Gebauer F, Hentze MW (2004) Molecular mechanisms of translational control. Nat Rev Mol Cell Biol 5(10):827–835
Sonenberg N, Hinnebusch AG (2009) Regulation of translation initiation in eukaryotes: mechanisms and biological targets. Cell 136(4):731–745
Hershko A, Ciechanover A (1998) The ubiquitin system. Annu Rev Biochem 67:425–479
King RW, Deshaies RJ, Peters JM, Kirschner MW (1996) How proteolysis drives the cell cycle. Science 274(5293):1652–1659
Acknowledgments
This work was funded by grants to GD from MIUR—Ministero dell’Istruzione, dell’Università e della Ricerca (no. 20093WAPYK_003) and from AIRC—Associazione Italiana per la Ricerca sul Cancro (project no. IG 10296).
Conflict of interest statement
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Pegolo, E., Puppin, C., Gerometta, A. et al. One-step nucleic acid amplification (OSNA) for intraoperative evaluation of sentinel lymph node status in breast cancer: a comparative study between CK19 protein expression and CK19 mRNA level in primary tumors and lymph node metastasis. Virchows Arch 463, 7–15 (2013). https://doi.org/10.1007/s00428-013-1440-2
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00428-013-1440-2