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Annals of Surgical Oncology

, Volume 21, Issue 12, pp 3924–3930 | Cite as

The Diagnostic Value of One-Step Nucleic acid Amplification (OSNA) for Sentinel Lymph Nodes in Colon Cancer Patients

  • F. J. Vogelaar
  • M. S. Reimers
  • R. L. A. van der Linden
  • J. C. van der Linden
  • V. T. H. B. M. Smit
  • D. J. Lips
  • C. J. H. van de Velde
  • K. BosschaEmail author
Colorectal Cancer

Abstract

Background

Lymph node status in colon cancer is critical for prognosis estimation and treatment allocation. The purpose of this study was to compare the performance of one-step nucleic acid amplification (OSNA) through detection of cytokeratin 19 mRNA levels with routine pathological examination (RP) and multilevel fine pathological examination (FP) in sentinel lymph nodes (SLN), detected using the ex vivo SLN mapping (SLNM) procedure, in presurgically defined nonmetastatic colon cancer patients.

Methods

In this prospective study, 325 SLNs of 128 patients from the Jeroen Bosch Hospital in ‘s-Hertogenbosch and the Leiden University Medical Center were investigated by RP (H&E), FP (H&E and Keratin Pan immunohistochemical staining), and OSNA. The SLNs were harvested by the SLNM procedure, using Patent blue or Indocyanine green. SLNs were divided and separate parts were used for RP, FP, and the OSNA assay.

Results

The diagnostic value of OSNA was 82.1 and 100 % for both FP and combined method (OSNA and FP) compared with RP. An upstaging rate of 20.2 % was obtained with the use of OSNA only and 36.4 % with the use of FP only. An upstaging rate of 46.5 % was obtained by combining the two methods together.

Conclusions

OSNA and FP appeared to be promising tools for the detection of lymph node micro- and macrometastases in SLNs after SLNM. The performances of OSNA and FP in this study were superior to RP. Because OSNA allows analysis of the whole lymph node, sampling bias can be avoided. OSNA therefore may improve tumor staging.

Keywords

Sentinel Lymph Node Fine Pathological Isolate Tumor Cell Sentinel Lymph Node Mapping Routine Pathological 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

The authors thank the image-guided surgery group from the LUMC for their help and expertise in the detection of SLNs, Dr. Liefers for advise and data interpretation, Dr. Takata for the study design and data interpretation, M. Hilbink for statistical advise, J. Damen and N.ter Haar for technical support, and Sysmex Corporation for technical support and providing study material.

Disclosures

None.

Supplementary material

10434_2014_3820_MOESM1_ESM.pdf (84 kb)
Supplementary material 1 (PDF 84 kb)

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • F. J. Vogelaar
    • 1
    • 3
  • M. S. Reimers
    • 4
  • R. L. A. van der Linden
    • 2
  • J. C. van der Linden
    • 2
  • V. T. H. B. M. Smit
    • 5
  • D. J. Lips
    • 1
  • C. J. H. van de Velde
    • 4
  • K. Bosscha
    • 1
    Email author
  1. 1.Department of SurgeryJeroen Bosch Hospital‘s-HertogenboschThe Netherlands
  2. 2.Department of PathologyJeroen Bosch Hospital‘s-HertogenboschThe Netherlands
  3. 3.Department of SurgeryVieCuri Medical CenterVenloThe Netherlands
  4. 4.Department of SurgeryLeiden University Medical CenterLeidenThe Netherlands
  5. 5.Department of PathologyLeiden University Medical CenterLeidenThe Netherlands

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