Bruno Märkl1, Bianca Grosser1, Kerstin Bauer1, Dmytro Vlasenko2, Gerhard Schenkirsch3, Andreas Probst4, Bernadette Kriening2. 1. Institute of Pathology and Molecular Diagnostics, University Hospital Augsburg, 86156 Augsburg, Germany. 2. Department of Visceral Surgery, University Hospital Augsburg, 86156 Augsburg, Germany. 3. Tumor Data Management, University Hospital Augsburg, 86156 Augsburg, Germany. 4. Medicine III-Gastroenterology, University Hospital of Augsburg, 86156 Augsburg, Germany.
Abstract
BACKGROUND: In this study, the effectiveness of One-step nucleic acid amplification (OSNA) in combination with ex vivo SLN mapping is compared with conventional histology including immunohistochemistry. METHODS: LNs were retrieved from gastrectomy specimens in an unfixed state. After ex vivo SLN mapping using methylene-blue, LNs were sliced to provide samples for histology and OSNA. RESULTS: In total, 334 LNs were retrieved in the fresh state from 41 patients. SLN detection was intended in 40 cases but was successful in only 29, with a correct LN status prediction in 23 cases (79%). Excluding one case out of 41 with a failure likely caused by a processing error, OSNA showed a high effectiveness with sensitivity, specificity, and accuracy rates of 85.4%, 93.5%, and 92.4%, respectively. The LN status could be predicted in all but one case, in which the single positive LN was not eligible for OSNA testing. Moreover, OSNA evaluation led to upstaging from N0 to N+ in three cases (14%). CONCLUSION: The ex vivo SLN protocol used resulted in a relatively poor detection rate. However, the OSNA method was not hampered by this detection rate and proved its potential to increase the sensitivity of metastases detection.
BACKGROUND: In this study, the effectiveness of One-step nucleic acid amplification (OSNA) in combination with ex vivo SLN mapping is compared with conventional histology including immunohistochemistry. METHODS: LNs were retrieved from gastrectomy specimens in an unfixed state. After ex vivo SLN mapping using methylene-blue, LNs were sliced to provide samples for histology and OSNA. RESULTS: In total, 334 LNs were retrieved in the fresh state from 41 patients. SLN detection was intended in 40 cases but was successful in only 29, with a correct LN status prediction in 23 cases (79%). Excluding one case out of 41 with a failure likely caused by a processing error, OSNA showed a high effectiveness with sensitivity, specificity, and accuracy rates of 85.4%, 93.5%, and 92.4%, respectively. The LN status could be predicted in all but one case, in which the single positive LN was not eligible for OSNA testing. Moreover, OSNA evaluation led to upstaging from N0 to N+ in three cases (14%). CONCLUSION: The ex vivo SLN protocol used resulted in a relatively poor detection rate. However, the OSNA method was not hampered by this detection rate and proved its potential to increase the sensitivity of metastases detection.
Authors: Sofía del Carmen; Sonia Gatius; Guzmán Franch-Arcas; José Antonio Baena; Oscar Gonzalez; Carlos Zafon; Dolors Cuevas; Joan Valls; Angustias Pérez; Mercedes Martinez; Susana Ros; Carmen García Macías; Carmela Iglesias; Xavier Matías-Guiu; Enrique de Álava Journal: Hum Pathol Date: 2015-10-03 Impact factor: 3.466