The advantage of one‐step nucleic acid amplification for the diagnosis of lymph node metastasis in colorectal cancer patients

Hiyoshi, Yukiharu; Akiyoshi, Takashi; Fukunaga, Yosuke

doi:10.1002/ags3.12392

Cited by 7 publications

(9 citation statements)

References 46 publications

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“…In our previous published study[ 127 ], OSNA was superior to HE in identifying LNMs, with a false negative rate of 0% vs 44.4% and accuracy of 100% vs 76.4%, respectively (Table 2 ). As represented in Tables 2 and 3 , few studies evaluated HE and IHC, few performed multi-sliced tissue sections using HE and the remaining single slice HE tissue section vs OSNA[ 11 , 128 - 131 ]. While the detection of small metastatic foci in LNs is influenced by the skill and experience of the pathologists, the advantage of the OSNA assay is the possibility to perform standard evaluations without being influenced by operator skill or experience.…”

Section: Diagnostic Performance Of the Osna Assay In Crcmentioning

confidence: 99%

Role of one-step nucleic acid amplification in colorectal cancer lymph node metastases detection

Crafa¹,

Vanella²,

Catalano³

et al. 2022

WJG

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Current histopathological staging procedures in colorectal cancer (CRC) depend on midline division of the lymph nodes (LNs) with one section of hematoxylin and eosin staining. Cancer cells outside this transection line may be missed, which could lead to understaging of Union for International Cancer Control Stage II high-risk patients. The one-step nucleic acid amplification (OSNA) assay has emerged as a rapid molecular diagnostic tool for LN metastases detection. It is a molecular technique that can analyze the entire LN tissue using a reverse-transcriptase loop-mediated isothermal amplification reaction to detect tumor-specific cytokeratin 19 mRNA. Our findings suggest that the OSNA assay has a high diagnostic accuracy in detecting metastatic LNs in CRC and a high negative predictive value. OSNA is a standardized, observer-independent technique, which may lead to more accurate staging. It has been suggested that in stage II CRC, the upstaging can reach 25% and these patients can access postoperative adjuvant chemotherapy. Moreover, intraoperative OSNA sentinel node evaluation may allow early CRC to be treated with organ-preserving surgery, while in more advanced-stage disease, a tailored lymphadenectomy can be performed considering the presence of aberrant lymphatic drainage and skip metastases.

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Section: Diagnostic Performance Of the Osna Assay In Crcmentioning

confidence: 99%

Role of one-step nucleic acid amplification in colorectal cancer lymph node metastases detection

Crafa¹,

Vanella²,

Catalano³

et al. 2022

WJG

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“…In other words, application to chemotherapy depends on an incidental encounter of micrometastases. In this regard, OSNA takes advantage because it checks up a piece of LN as a bulk sample; thus, a stable detection ability will be warranted 41 . It should be emphasized that the OSNA assay provides a judgment performance equivalent to histopathological examination of three slices at a 2‐mm‐interval (Figure 1, Study 2).…”

Section: Can Micrometastases Be a Target For Adjuvant Chemotherapy?mentioning

confidence: 99%

“…In this regard, OSNA takes advantage because it checks up a piece of LN as a bulk sample; thus, a stable detection ability will be warranted. 41 It should be emphasized that the OSNA assay provides a judgment performance equivalent to histopathological examination of three slices at a 2‐mm‐interval (Figure 1 , Study 2). Thus, it is likely that OSNA test would contribute efficient detection of micrometastasis compared with the pathological routine survey with one slice.…”

Section: Can Micrometastases Be a Target For Adjuvant Chemotherapy?mentioning

confidence: 99%

Micrometastasis in lymph nodes of colorectal cancer

Yamamoto

2022

Annals of Gastroent Surgery

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Colorectal cancer (CRC) is one of the most common cancers worldwide. Postoperative adjuvant chemotherapy is recommended for node‐positive stage III patients. A systematic meta‐analysis reported that the presence of micrometastases in regional lymph nodes (LNs) was associated with poor survival in patients with node‐negative CRC. Because most data employed in the meta‐analysis were based on retrospective studies, we conducted a prospective clinical trial and concluded that stage II is a transitional zone between stage I and stage III, where CRC tumors continuously increase the micrometastasis volume in LNs and proportionally raise the risk for tumor recurrence. The one‐step nucleic acid amplification (OSNA) assay is a simple and rapid technique to detect CK19 mRNA using the reverse‐transcription loop‐mediated isothermal amplification (RT‐LAMP) method. Using the OSNA assay, we and colleagues reported that the upstaging rates of pStages I, IIA, IIB, and IIC were 2.0%, 17.7%, 12.5%, and 25%, respectively, in 124 node‐negative patients. Survival analysis indicated that OSNA positive stage II CRC patients had a shorter 3‐y disease‐free survival rate than OSNA negative stage II CRC patients. In 2017, AJCC TNM staging (the 8th version) revised the definition of LN metastasis in colon cancer and it is stated that micrometastasis should be considered as a standard LN metastasis. To our surprise, this revision was based on a meta‐analysis to which our previous study on micrometastasis largely contributed. The remaining questions to be addressed are how to find micrometastases efficiently and whether postadjuvant chemotherapy is effective to prevent disease recurrence and to contribute to longer survival.

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“…The available scientific and clinical evidence, together with the mentioned characteristics, has introduced OSNA in current national and European clinical guidelines as an alternative technique for the determination of lymphatic involvement in breast cancer through SLN analysis [ 18 ]. Moreover, data available from studies in colorectal cancer demonstrated that OSNA is a valid technique for the detection of lymphatic involvement also in this cancer entity [ 19 ]. Hence, OSNA is now included in the recommendations for the determination of biomarkers in colorectal carcinoma [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Application of One-Step Nucleic Acid Amplification (OSNA) in different cancer entities and usefulness in prostate cancer: a systematic review

et al. 2022

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Background Lymph node (LN) status is a key prognostic factor in the decision-making process of different cancer entities, including prostate cancer (PCa). Sectioning and haematoxylin and eosin (H&E) staining technique remain the gold standard for the evaluation of LN metastases despite some limitations, especially low sensitivity in detecting an accurate tumour burden within the LN, as well as a subjective and time-consuming result. One-step nucleic acid amplification (OSNA) quantifies mRNA copies of cytokeratin 19 (CK19) in a fast, objective, automated, and reproducible way, raising a general interest to explore its utility for lymphatic metastasis identification in different malignancies. Methods To present the latest evidence related to the detection of LN metastases in several tumours by using OSNA compared with the conventional H&E method, a systematic review of articles published since March 2021 was conducted using PubMed, Cochrane Library, and Web of Science databases. References from primary papers and review articles were checked to obtain further potential studies. Our procedure for evaluating records identified during the literature search followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria. With the aim to design and justify future clinical routine use of OSNA in PCa, novel PCa evidence has been included in this review for the first time. Results Twenty five studies were included. LN from six different groups of tumours: breast, gastrointestinal, gynecological, lung, head and neck and prostate cancers has been assessed. OSNA was compared with post-operative formalin-fixed paraffin-embedded tissue sections with H&E staining as the reference standard. Contingency tables were created, and concordance rate, sensitivity, specificity and predictive values were reported. Seventeen studies analysed the discordant cases using different techniques. Conclusion OSNA method has a high diagnostic accuracy for the detection of LN metastases in several CK19 expressing tumours. Available evidence might encourage future investigations about its usage in PCa patients to improve LN staging and prognosis.

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The advantage of one‐step nucleic acid amplification for the diagnosis of lymph node metastasis in colorectal cancer patients

Cited by 7 publications

References 46 publications

Role of one-step nucleic acid amplification in colorectal cancer lymph node metastases detection

Role of one-step nucleic acid amplification in colorectal cancer lymph node metastases detection

Micrometastasis in lymph nodes of colorectal cancer

Application of One-Step Nucleic Acid Amplification (OSNA) in different cancer entities and usefulness in prostate cancer: a systematic review

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