Standard ultra-staging compared to one-step nucleic acid amplification for the detection of sentinel lymph node metastasis in endometrial cancer patients: a retrospective cohort comparison.
Aged
Cohort Studies
Endometrial Neoplasms
/ genetics
Female
Humans
Keratin-19
/ analysis
Lymph Nodes
/ pathology
Lymphatic Metastasis
Middle Aged
Neoplasm Staging
Nucleic Acid Amplification Techniques
/ methods
RNA, Messenger
/ analysis
Retrospective Studies
Sentinel Lymph Node
/ chemistry
Sentinel Lymph Node Biopsy
/ methods
endometrium
pathology
sentinel lymph node
Journal
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
ISSN: 1525-1438
Titre abrégé: Int J Gynecol Cancer
Pays: England
ID NLM: 9111626
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
15
09
2019
revised:
05
12
2019
accepted:
10
12
2019
pubmed:
31
1
2020
medline:
25
8
2020
entrez:
31
1
2020
Statut:
ppublish
Résumé
The objective of this study was to compared standard ultra-staging (SU) with one-step nucleic acid amplification (OSNA) for the detection of sentinel lymph node (SLN) metastasis in women with apparent uterine-confined endometrial cancer. All women underwent SLN identification with complete surgical staging. All SLNs were cut perpendicular to the long axis and two adjacent 5 µm sections were cut at each of two levels 50 µm apart. At each level, one slide was stained with hematoxylin and eosin and the other with immunohistochemistry using the AE1/AE3 anti-cytokeratin antibody, as well as one negative control slide for a total of five slides per block. For OSNA analysis, the 2 mm sections of the lymph nodes were homogenized to form a lysate. The lysate was then centrifuged and inserted into the RD 100i instrument where the isothermal amplification of CK19 mRNA was executed. Of the 396 patients included in the retrospective analysis, 214 were in the SU group, and 182 in the OSNA group. Overall 869 SLNs were identified (490 SU, 379 OSNA). Sixty patients exhibited SLN metastasis (34 SU, 26 OSNA). Macrometastasis, micrometastases, and isolated tumor cells (ITC) were 5.1%, 4.1%, and 0.2%, respectively, in the US group, and 2.4%, 6.3%, and 0.1%, respectively, in the OSNA group (p=0.022). The OSNA assay detected a higher rate of micrometastasis and a lower rate of macrometastasis and ITC when compared with SU. The clinical and prognostic impact of ITC is debatable and controversial. Further studies are needed to clarify the respective roles of the OSNA and SU methods, and the possible role of ITC in the prognosis of patients with apparent early-stage endometrial cancer.
Identifiants
pubmed: 31996396
pii: ijgc-2019-000937
doi: 10.1136/ijgc-2019-000937
doi:
Substances chimiques
KRT19 protein, human
0
Keratin-19
0
RNA, Messenger
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
372-377Informations de copyright
© IGCS and ESGO 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.