Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Virchows Archiv
Published in: Virchows Archiv 2/2009

Open Access 01-02-2009 | Original Article

One-step nucleic acid amplification—a molecular method for the detection of lymph node metastases in breast cancer patients; results of the German study group

Authors: Christian Schem, Nicolai Maass, Dirk O. Bauerschlag, Martin H. Carstensen, Thomas Löning, Christian Roder, Olivera Batic, Walter Jonat, Katharina Tiemann

Published in: Virchows Archiv | Issue 2/2009

Login to get access

Abstract

Sentinel lymph node (SN) biopsy is part of the staging procedure in breast cancer patients. In this study, we compared an intraoperative tool named one-step nucleic acid amplification (OSNA) to our routine histological investigation. OSNA consists of a short homogenization step followed by amplification of cytokeratin (CK) 19 mRNA directly from the lysate. To evaluate the performance of OSNA in comparison to histology, analysis of 343 axillary lymph nodes (ALN) from 93 breast cancer patients was performed with both methods. Discordant samples were subjected to other methods. If these tests supported the OSNA results, these samples were excluded from the study. The concordance rate was 91.8%, sensitivity 98.1%, and specificity 90.8% before and 95.5%, 100%, and 95.6%, respectively, after discordant case investigation. Our results show that OSNA is an excellent method for the detection of metastases in lymph nodes and can be applied as an intraoperative diagnostic approach.
Literature
1.
Morton DL, Wen DR, Wong JH et al (1992) Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 127:392–399PubMed
2.
Golshan M, Martin WJ, Dowlatshahi K et al (2003) Sentinel lymph node biopsy lowers the rate of lymphedema when compared with standard axillary lymph node dissection. Am Surg 69:209–211PubMed
3.
Veronesi U, Paganelli G, Viale G et al (1999) Sentinel lymph node biopsy and axillary dissection in breast cancer: results in a large series. J Natl Cancer Inst 91:368–373PubMedCrossRef
4.
Lyman GH, Giuliano AE, Somerfield MR et al (2005) American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol 23:7703–7720PubMedCrossRef
5.
Ferrari A, Rovera F, Dionigi P et al (2006) Sentinel lymph node biopsy as the new standard of care in the surgical treatment for breast cancer. Expert Rev Anticancer Ther 6:1503–1515PubMedCrossRef
6.
Mabry H, Giuliano AE (2007) Sentinel node mapping for breast cancer: progress to date and prospects for the future. Surg Oncol Clin N Am 16:55–70PubMedCrossRef
7.
Motomura K, Inaji H, Komoike Y et al (2000) Intraoperative sentinel lymph node examination by imprint cytology and frozen sectioning during breast surgery. Br J Surg 87:597–601PubMedCrossRef
8.
Creager AJ, Geisinger KR, Shiver SA et al (2002) Intraoperative evaluation of sentinel lymph nodes for metastatic breast carcinoma by imprint cytology. Mod Pathol 15:1140–1147PubMedCrossRef
9.
Leidenius MH, Krogerus LA, Toivonen TS et al (2003) The feasibility of intraoperative diagnosis of sentinel lymph node metastases in breast cancer. J Surg Oncol 84:68–73PubMedCrossRef
10.
Brogi E, Torres-Matundan E, Tan LK et al (2005) The results of frozen section, touch preparation, and cytological smear are comparable for intraoperative examination of sentinel lymph nodes: a study in 133 breast cancer patients. Ann Surg Oncol 12:173–180PubMedCrossRef
11.
Cserni G, Amendoeira I, Apostolikas N et al (2003) Pathological work-up of sentinel lymph nodes in breast cancer. Review of current data to be considered for the formulation of guidelines. Eur J Cancer 39:1654–1667PubMedCrossRef
12.
Cserni G, Amendoeira I, Apostolikas N et al (2004) Discrepancies in current practice of pathological evaluation of sentinel lymph nodes in breast cancer. Results of a questionnaire based survey by the European Working Group for Breast Screening Pathology. J Clin Pathol 57:695–701PubMedCrossRef
13.
Roberts CA, Beitsch PD, Litz CE et al (2003) Interpretive disparity among pathologists in breast sentinel lymph node evaluation. Am J Surg 186:324–329PubMedCrossRef
14.
Mitas M, Mikhitarian K, Walters C et al (2001) Quantitative real-time RT-PCR detection of breast cancer micrometastases using a multigene marker panel. Int J Cancer 93:162–171PubMedCrossRef
15.
Weigelt B, Verduijn P, Bosma AJ et al (2004) Detection of metastases in sentinel lymph nodes of breast cancer patients by multiple mRNA markers. Br J Cancer 90:1531–1537PubMedCrossRef
16.
Nissan A, Jager D, Roystacher M et al (2004) Multimarker RT-PCR assay for the detection of minimal residual disease in sentinel lymph nodes of breast cancer patients. Br J Cancer 94:681–685
17.
Gimbergues P, Dauplat MM, Cayre A et al (2007) Correlation between molecular metastases in sentinel lymph nodes of breast cancer patients and St Gallen risk category. Eur J Surg Oncol 33:16–22PubMed
18.
Gillanders WE, Mikhitarian K, Hebert R et al (2004) Molecular detection of micrometastatic breast cancer in histopathology-negative axillary lymph nodes correlates with traditional predictors of prognosis: an interim analysis of a prospective multi-institutional cohort study. Ann Sur 239:828–837, discussion 837–840CrossRef
19.
Julian TB, Blumencranz P, Deck K et al (2008) Novel intraoperative molecular test for sentinel lymph node metastases in patients with early-stage breast cancer. J Clin Oncol 26:3338–3345PubMedCrossRef
20.
Tsujimoto M, Nakabayashi K, Yoshidome K et al (2007) One-Step Nucleic Acid Amplification (OSNA) for intraoperative detection of lymph node metastasis in breast cancer patients. Clin Can Res 13:4807–4816CrossRef
21.
Visser M, Jiwa M, Horstman A et al (2008) Intra-operative rapid diagnostic method based on CK19 mRNA expression for the detection of lymph node metastases in breast cancer. Int J Cancer 122:2562–2567PubMedCrossRef
22.
Taniyama K, Motoshita J, Sakane J et al (2006) Combination analysis of a whole lymph node by one-step nucleic acid amplification and histology for intraoperative detection of micrometastasis. Pathobiology 73:183–191PubMedCrossRef
23.
Notomi T, Okayama H, Masubuchi H et al (2000) Loop-mediated isothermal amplification of DNA. Nucleic Acids Research 28:e63PubMedCrossRef
24.
Mori Y, Nagamine K, Tomita N et al (2001) Detection of loop-mediated isothermal amplification reaction by turbidity derived from magnesium pyrophosphate formation. Biochem Biophys Res Commun 289:150–154PubMedCrossRef
25.
Sobin LH, Wittekind C et al (2002) UICC TNM classification of malignant tumours, 6th edn. John Wiley & Sons, Inc., New York
26.
Singletary SE, Greene FL (2003) Revision of breast cancer staging: the 6th edition of the TNM classification. Semin Surg Oncol 21:53–59PubMedCrossRef
27.
Blumencranz P, Whitworth PW, Deck K et al (2007) Sentinel node staging for breast cancer: intraoperative molecular pathology overcomes conventional histologic sampling errors. Am J Surg 194:426–432PubMedCrossRef
28.
Daniele L, Annaratone L, Allia E et al (2008) Technical limits of comparison of step-sectioning, immunohistochemistry and RT-PCR on breast cancer sentinel nodes: a study on methacarn fixed tissue. J Cell Mol Med (in press)
29.
Kreienberg R, Kopp I, Albert U et al (2008) Interdisciplinary S3-Guideline for breast cancer diagnostic procedures, therapy and follow-up. (article in German) W. Zuckschwerdt Verlag 1. Aktualisierung 02/2008, ISBN: 978-3-88603-934-0
30.
Chu PG, Weiss LM (2002) Keratin expression in human tissues and neoplasms. Histopathology 40:403–439PubMedCrossRef
Metadata
Title
One-step nucleic acid amplification—a molecular method for the detection of lymph node metastases in breast cancer patients; results of the German study group
Authors
Christian Schem
Nicolai Maass
Dirk O. Bauerschlag
Martin H. Carstensen
Thomas Löning
Christian Roder
Olivera Batic
Walter Jonat
Katharina Tiemann
Publication date
01-02-2009
Publisher
Springer-Verlag
Published in
Virchows Archiv / Issue 2/2009
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI
https://doi.org/10.1007/s00428-008-0703-9

Other articles of this Issue 2/2009

Virchows Archiv 2/2009 Go to the issue

Erratum

Expression of estrogen receptor co-regulators NCoR and PELP1 in epithelial cells and myofibroblasts of colorectal carcinomas. Cytoplasmic translocation of NCoR in epithelial cells correlates with better prognosis

Original Article

Biomaterial-induced sarcomagenesis is not associated with microsatellite instability

Original Article

Active neovascularization and possible vascular-centric development of gastric and periscapular elastofibromas

Original Article

Prevalence of Helicobacter pylori infection, chronic gastritis, and intestinal metaplasia in Mozambican dyspeptic patients

Review and Perspective

Retroperitoneal margin of the pancreaticoduodenectomy specimen: anatomic mapping for the surgical pathologist

Original Article

Histopathological predictor for regional lymph node metastasis in gastric cancer