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Diestro MD, Berjón A, Zapardiel I, Yébenes L, Ruiz I, Lekuona A, Rezola M, Jaunarena I, Siegrist J, Sánchez-Pastor M, Cuadra M, Sagasta A, Guerra I, Lete LI, Roldán F, Marta CB, Boillos MJ, Cardiel MJ, López-de la Manzanara C, Relea F, Coronado PJ, Pascual A, Román MJ, Peiró G, Matute LJ, Montero B, Muruzábal JC, Guarch R, Zorrero C, Calatrava A, Ribot L, Costa I, Hernández A, Hardisson D. One-Step Nucleic Acid Amplification (OSNA) of Sentinel Lymph Node in Early-Stage Endometrial Cancer: Spanish Multicenter Study (ENDO-OSNA). Cancers (Basel) 2021; 13:4465. [PMID: 34503275 PMCID: PMC8431061 DOI: 10.3390/cancers13174465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 12/24/2022] Open
Abstract
The objective of this study was to evaluate the efficacy of one-step nucleic acid amplification (OSNA) for the detection of sentinel lymph node (SLN) metastasis compared to standard pathological ultrastaging in patients with early-stage endometrial cancer (EC). A total of 526 SLNs from 191 patients with EC were included in the study, and 379 SLNs (147 patients) were evaluated by both methods, OSNA and standard pathological ultrastaging. The central 1 mm portion of each lymph node was subjected to semi-serial sectioning at 200 μm intervals and examined by hematoxylin-eosin and immunohistochemistry with CK19; the remaining tissue was analyzed by OSNA for CK19 mRNA. The OSNA assay detected metastases in 19.7% of patients (14.9% micrometastasis and 4.8% macrometastasis), whereas pathological ultrastaging detected metastasis in 8.8% of patients (3.4% micrometastasis and 5.4% macrometastasis). Using the established cut-off value for detecting SLN metastasis by OSNA in EC (250 copies/μL), the sensitivity of the OSNA assay was 92%, specificity was 82%, diagnostic accuracy was 83%, and the negative predictive value was 99%. Discordant results between both methods were recorded in 20 patients (13.6%). OSNA resulted in an upstaging in 12 patients (8.2%). OSNA could aid in the identification of patients requiring adjuvant treatment at the time of diagnosis.
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Affiliation(s)
- María Dolores Diestro
- Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ), Faculty of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain; (I.Z.); (J.S.); (M.S.-P.); (A.H.)
| | - Alberto Berjón
- Department of Pathology, Hospital Universitario La Paz, Molecular Pathology and Therapeutic Targets Group, Hospital La Paz Institute for Health Research (IdiPAZ), Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Faculty of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain; (A.B.); (L.Y.)
| | - Ignacio Zapardiel
- Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ), Faculty of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain; (I.Z.); (J.S.); (M.S.-P.); (A.H.)
| | - Laura Yébenes
- Department of Pathology, Hospital Universitario La Paz, Molecular Pathology and Therapeutic Targets Group, Hospital La Paz Institute for Health Research (IdiPAZ), Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Faculty of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain; (A.B.); (L.Y.)
| | - Irune Ruiz
- Department of Pathology, Hospital Universitario Donostia Osakidetza, 20014 Donostia, Spain; (I.R.); (M.R.)
| | - Arantza Lekuona
- Department of Gynecology, Hospital Universitario Donostia Osakidetza, 20014 Donostia, Spain; (A.L.); (I.J.)
| | - Marta Rezola
- Department of Pathology, Hospital Universitario Donostia Osakidetza, 20014 Donostia, Spain; (I.R.); (M.R.)
| | - Ibon Jaunarena
- Department of Gynecology, Hospital Universitario Donostia Osakidetza, 20014 Donostia, Spain; (A.L.); (I.J.)
| | - Jaime Siegrist
- Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ), Faculty of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain; (I.Z.); (J.S.); (M.S.-P.); (A.H.)
| | - Margarita Sánchez-Pastor
- Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ), Faculty of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain; (I.Z.); (J.S.); (M.S.-P.); (A.H.)
| | - María Cuadra
- Department of Gynecology, Instituto de Investigación Bioaraba, OSI Araba Hospital Universitario, 01009 Vitoria-Gasteiz, Spain; (M.C.); (L.I.L.)
| | - Amaia Sagasta
- Department of Pathology, Instituto de Investigación Bioaraba, OSI Araba Hospital Universitario, 01009 Vitoria-Gasteiz, Spain; (A.S.); (I.G.)
| | - Isabel Guerra
- Department of Pathology, Instituto de Investigación Bioaraba, OSI Araba Hospital Universitario, 01009 Vitoria-Gasteiz, Spain; (A.S.); (I.G.)
| | - Luis I. Lete
- Department of Gynecology, Instituto de Investigación Bioaraba, OSI Araba Hospital Universitario, 01009 Vitoria-Gasteiz, Spain; (M.C.); (L.I.L.)
| | - Fernando Roldán
- Department of Gynecology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (F.R.); (M.J.B.)
| | - Carlo B. Marta
- Department of Pathology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (C.B.M.); (M.J.C.)
| | - María J. Boillos
- Department of Gynecology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (F.R.); (M.J.B.)
| | - María J. Cardiel
- Department of Pathology, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain; (C.B.M.); (M.J.C.)
| | - Carlos López-de la Manzanara
- Department of Gynecology, Hospital General Universitario Ciudad Real, Universidad de Castilla-La Mancha, 13005 Ciudad Real, Spain;
| | - Fernanda Relea
- Department of Pathology, Hospital General Universitario Ciudad Real, Universidad de Castilla-La Mancha, 13005 Ciudad Real, Spain;
| | - Pluvio J. Coronado
- Women Health Institute, Hospital Clínico Universitario San Carlos, IdISSC, Complutense University, 28040 Madrid, Spain;
| | - Alejandro Pascual
- Department of Pathology, Hospital Clínico Universitario San Carlos, 28040 Madrid, Spain;
| | - María J. Román
- Department of Gynecology, Hospital General Universitario Alicante and Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain;
| | - Gloria Peiró
- Department of Pathology, Hospital General Universitario Alicante and Alicante Institute for Health and Biomedical Research (ISABIAL), 03010 Alicante, Spain;
| | - Luis J. Matute
- Department of Gynecology, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;
| | - Beatriz Montero
- Department of Pathology, Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain;
| | - Juan C. Muruzábal
- Department of Gynecology, Complejo Hospitalario Universitario Navarra, 31008 Pamplona, Spain;
| | - Rosa Guarch
- Department of Pathology, Complejo Hospitalario Universitario Navarra, 31008 Pamplona, Spain;
| | - Cristina Zorrero
- Department of Gynecology, Hospital Fundación IVO, 46009 Valencia, Spain;
| | - Ana Calatrava
- Department of Pathology, Hospital Fundación IVO, 46009 Valencia, Spain;
| | - Laia Ribot
- Department of Gynecology, Corporación Sanitaria Parc Taulí Sabadell, 08208 Barcelona, Spain;
| | - Irmgard Costa
- Department of Pathology, Corporación Sanitaria Parc Taulí Sabadell, 08208 Barcelona, Spain;
| | - Alicia Hernández
- Gynecologic Oncology Unit, Department of Gynecology and Obstetrics, Hospital Universitario La Paz, Hospital La Paz Institute for Health Research (IdiPAZ), Faculty of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain; (I.Z.); (J.S.); (M.S.-P.); (A.H.)
| | - David Hardisson
- Department of Pathology, Hospital Universitario La Paz, Molecular Pathology and Therapeutic Targets Group, Hospital La Paz Institute for Health Research (IdiPAZ), Center for Biomedical Research in the Cancer Network (Centro de Investigación Biomédica en Red de Cáncer, CIBERONC), Instituto de Salud Carlos III, Faculty of Medicine, Universidad Autónoma de Madrid, 28046 Madrid, Spain; (A.B.); (L.Y.)
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