Κυριακή 2 Φεβρουαρίου 2020

One-step nucleic acid amplification for detecting lymph node metastasis of head and neck squamous cell carcinoma.

One-step nucleic acid amplification for detecting lymph node metastasis of head and neck squamous cell carcinoma.:

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One-step nucleic acid amplification for detecting lymph node metastasis of head and neck squamous cell carcinoma.

Oral Oncol. 2020 Jan 28;102:104553

Authors: Peigné L, Godey F, Le Gallo M, Le Gall F, Fautrel A, Morcet J, Jégoux F

Abstract

BACKGROUND: In head and neck squamous cell carcinoma (HNSCC) 30% of cN0 patients have occult metastasis. LN invasion is a major prognostic factor. Sentinel lymph node (SLN) is an option for cN0 neck management. One-step nucleic acid amplification (OSNA) used to analyze SLN in breast cancer is also a candidate to get more reliable intraoperative HNSCC lymph node (LN) staging.

OBJECTIVE: To compare OSNA analysis to pathological analysis in cN0 HNSCC.

MATERIALS AND METHODS: 157 LN from 26 cN0 HNSCC patients were prospectively analyzed (6.3LN/patient). Exclusion criteria were previous surgery or radiotherapy. Each node was cut into 4 equal pieces alternatively sent to pathological analysis and OSNA technique. IHC CK19 was performed on the primary tumor biopsy and RT-qPCR of CK19, PVA and EPCAM on the LN lysate of discordant cases.

RESULTS: OSNA was able to provide intraoperative result in all patients. OSNA detected 21 metastases. There were 139 concordant LN (88.5%). There were 18 initial discordant LN (11.5%), 13 (8.3%) were OSNA positive/pathological analysis negative, 5 (3.2%) were OSNA negative/pathological analysis positive. After elimination of allocation bias, false negative rate was 1.3%, sensitivity and specificity were 90% and 95.6%, PPV and NPV were 75% and 98.5%.

CONCLUSION: Our results suggest that OSNA should be considered to improve SNB analysis both for increasing micro metastasis diagnosis and offer extemporaneous results. Study registered under clinicaltrials.gov database number NCT02852343.

PMID: 32004908 [PubMed - as supplied by publisher]

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