Concordance study between one-step nucleic acid amplification and morphologic techniques to detect lymph node metastasis in papillary carcinoma of the thyroid
Issue date
2016Author
del Carmen, Sofía
Gatius Calderó, Sònia
Franch Arcas, Guzmán
Gonzalez, Oscar
Zafon, Carles
Cuevas Sánchez, Dolors
Valls Marsal, Joan
Pérez, Angustias
Martinez, Mercedes
Ros López, Susana
García Macías, Carmen
Iglesias, Carmela
de Álava, Enrique
Suggested citation
del Carmen, Sofía;
Gatius Calderó, Sònia;
Franch Arcas, Guzmán;
Baena-Fustegueras, Juan A;
Gonzalez, Oscar;
Zafon, Carles;
...
de Álava, Enrique.
(2016)
.
Concordance study between one-step nucleic acid amplification and morphologic techniques to detect lymph node metastasis in papillary carcinoma of the thyroid.
Human Pathology, 2016, vol. 48, p. 132–141.
https://doi.org/10.1016/j.humpath.2015.09.020.
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Show full item recordAbstract
Tumor resection in papillary thyroid carcinoma (PTC) is often accompanied by lymph node
(LN) removal of the central and lateral cervical compartments. One-step nucleic acid amplification
(OSNA) is a polymerase chain reaction–based technique that quantifies cytokeratin 19 (CK19)
messenger RNA copies. Our aim is to assess the value of OSNA in detection of LN metastases in PTC,
in comparison with imprints and microscopic analysis of formalin-fixed, paraffin-embedded (FFPE)
tissue. A total of 387 LNs from 37 patients were studied. From each half LN, 2 imprints were taken and
analyzed with hematoxylin and eosin (H&E) and CK19 immunostaining. One half of the LN was
submitted to OSNA and one half to FFPE processing and H&E and CK19 staining. For concordance
analysis, every single LN was considered as a case. A group of 11 cases with discordant results between
OSNA and H&E/CK19 FFPE sections were subjected to additional FFPE serial sectioning and H&E
and CK19 staining. We found a high degree of concordance between the assays used, with sensitivities
ranging from 0.81 to 0.95, and specificities ranging from 0.87 and 0.98. OSNA allowed upstaging of
patients from pN0 to pN1, in comparison with standard pathologic analysis. Identification of a
metastatic LN with more than 15000 CK19 messenger RNA copies predicted the presence of a second
LN with macrometastasis (b5000 copies). In summary, the study shows that OSNA application in
sentinel or suspicious LN may be helpful in assessing nodal status in PTC patients.
© 2015 Elsevier Inc. All rights reserved.