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Molecular investigation of lymph nodes in colon cancer patients using one-step nucleic acid amplification (OSNA)†‡
A new road to better staging?
Article first published online: 8 JUN 2012
Copyright © 2012 American Cancer Society
Volume 118, Issue 24, pages 6039–6045, 15 December 2012
How to Cite
Güller, U., Zettl, A., Worni, M., Langer, I., Cabalzar-Wondberg, D., Viehl, C. T., Demartines, N. and Zuber, M. (2012), Molecular investigation of lymph nodes in colon cancer patients using one-step nucleic acid amplification (OSNA). Cancer, 118: 6039–6045. doi: 10.1002/cncr.27667
Presented at the 97th Annual Congress of the Swiss Society of Surgery, May 26-28, 2010; Interlaken, Switzerland; at the International Sentinel Node Society Meeting; November 18-20, 2010; Yokohama, Japan; and at the Fourth International Symposium on Cancer Metastases and the Lymphovascular System; May 12-14, 2011; New York, NY.
Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/onlineopen#OnlineOpen_Terms
- Issue published online: 3 DEC 2012
- Article first published online: 8 JUN 2012
- Manuscript Accepted: 11 APR 2012
- Manuscript Revised: 9 APR 2012
- Manuscript Received: 4 JAN 2012
- Unknown funding agency
- one-step nucleic acid amplification;
- colon cancer;
- lymph node;
A new diagnostic system, called one-step nucleic acid amplification (OSNA), has recently been designed to detect cytokeratin 19 mRNA as a surrogate for lymph node metastases. The objective of this prospective investigation was to compare the performance of OSNA with both standard hematoxylin and eosin (H&E) analysis and intensive histopathology in the detection of colon cancer lymph node metastases.
In total, 313 lymph nodes from 22 consecutive patients with stage I, II, and III colon cancer were assessed. Half of each lymph node was analyzed initially by H&E followed by an intensive histologic workup (5 levels of H&E and immunohistochemistry analyses, the gold standard for the assessment of sensitivity/specificity of OSNA), and the other half was analyzed using OSNA.
OSNA was more sensitive in detecting small lymph node tumor infiltrates compared with H&E (11 results were OSNA positive/H&E negative). Compared with intensive histopathology, OSNA had 94.5% sensitivity, 97.6% specificity, and a concordance rate of 97.1%. OSNA resulted in an upstaging of 2 of 13 patients (15.3%) with lymph node-negative colon cancer after standard H&E examination.
OSNA appeared to be a powerful and promising molecular tool for the detection of lymph node metastases in patients with colon cancer. OSNA had similar performance in the detection of lymph node metastases compared with intensive histopathologic investigations and appeared to be superior to standard histology with H&E. Most important, the authors concluded that OSNA may lead to a potential upstaging of >15% of patients with colon cancer. Cancer 2012. © 2012 American Cancer Society.