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Kaczka KA, Pomorski L. One-step nucleic acid amplification analysis of sentinel lymph nodes in papillary thyroid cancer patients. Arch Med Sci. 2017;13(6):1416-1426doi: 10.5114/aoms.2017.65466.
Kaczka, K. A., & Pomorski, L. (2017). One-step nucleic acid amplification analysis of sentinel lymph nodes in papillary thyroid cancer patients. Archives of medical science : AMS, 13(6), 1416-1426. https://doi.org/10.5114/aoms.2017.65466
Kaczka, Krzysztof A, and Pomorski, Lech. "One-step nucleic acid amplification analysis of sentinel lymph nodes in papillary thyroid cancer patients." Archives of medical science : AMS vol. 13,6 (2017): 1416-1426. doi: https://doi.org/10.5114/aoms.2017.65466
Kaczka KA, Pomorski L. One-step nucleic acid amplification analysis of sentinel lymph nodes in papillary thyroid cancer patients. Arch Med Sci. 2017 Oct;13(6):1416-1426. doi: 10.5114/aoms.2017.65466. Epub 2017 Jan 25. PMID: 29181073; PMCID: PMC5701692.
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Arch Med Sci. 2017 Oct;13(6):1416-1426. doi: 10.5114/aoms.2017.65466. Epub 2017 Jan 25.

One-step nucleic acid amplification analysis of sentinel lymph nodes in papillary thyroid cancer patients.

Archives of medical science : AMS

Krzysztof A Kaczka, Lech Pomorski

Affiliations

  1. Department of General and Oncological Surgery, Medical University of Lodz, Lodz, Poland.

PMID: 29181073 PMCID: PMC5701692 DOI: 10.5114/aoms.2017.65466

Abstract

INTRODUCTION: It is essential to look for methods to define the need for central lymphadenectomy for papillary thyroid cancer patients. The aim is to determine the efficacy of one-step nucleic acid amplification (OSNA) and sentinel lymph node (SLN) biopsy in the intraoperative detection of nodal involvement.

MATERIAL AND METHODS: This prospective, experimental study enrolled 49 patients with clinically negative lymph nodes. Intraoperatively, 1% Patent Blue dye was injected intratumorally. Lymph nodes that stained blue were defined as SLNs. They were directly cut into blocks at 2-mm intervals. Nonadjacent blocks were subjected to either the OSNA assay or histological examination.

RESULTS: Sixty-five SLNs were found in 43 (87.8%) patients. There were 20 (30.8%) histopathologically positive SLNs. According to the OSNA, 22 (33.8%) SLNs were positive. The OSNA results were different from histopathology in 8 (12.3%) SLNs. The OSNA gave a positive result in 5 (7.7%) SLNs, while they were not involved according to the histopathology. However, OSNA upstaged N status from N0 to N1 only in 2 (3.1%) patients. Inverse results (histopathology +, OSNA-) were obtained in 3 (4.6%) SLNs. Positive and negative predictive values (PPV and NPV) for OSNA were 0.77 and 0.93, respectively. The concordance rate between examinations was 85.5%.

CONCLUSIONS: In some patients with clinically negative lymph nodes, OSNA and SLN biopsy may prevent unnecessary central lymphadenectomy. On the other hand, the sentinel lymph node biopsy may reveal the presence of potentially involved sentinel lymph nodes outside the central compartment. These SLNs can also be assessed by means of OSNA.

Keywords: lymph nodes; one-step nucleic acid amplification; papillary thyroid cancer

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