Utility of the one-step nucleic acid amplification assay in sentinel node mapping for early gastric cancer patients

Ayako Shimada, Hiroya Takeuchi, Tomohiko Nishi, Shuhei Mayanagi, Kazumasa Fukuda, Koichi Suda, Rieko Nakamura, Norihito Wada, Hirofumi Kawakubo, Tadaki Nakahara, Kaori Kameyama, Yuko Kitagawa

Research output: Contribution to journalArticle

Abstract

Background: To safely perform minimized gastrectomy based on sentinel node (SN) concept for early gastric cancer patients, intraoperative diagnostic accuracy is indispensable. This study aimed to evaluate the clinical utility of the one-step nucleic acid amplification (OSNA) assay in the intraoperative diagnosis of SN metastasis in early gastric cancer patients compared with that of histopathological examination. Methods: We conducted a prospective study using the OSNA assay for 43 patients with cT1N0M0 gastric cancer undergoing gastrectomy with SN mapping. All the SNs and selected non-SNs were examined by routine histopathological diagnosis, and the OSNA assay. Results: We performed permanent histopathology (PH) in 1732 lymph nodes (LNs) (286 SNs and 1446 non-SNs) obtained from 43 patients. We also evaluated 439 LNs (286 SNs and 153 non-SNs) with the OSNA assay in addition to PH. Intraoperative histopathology (IH) was performed in 214 LNs (213 SNs and 1 non-SN). PH revealed LN metastasis in 6 patients (14%), all of whom showed positive SNs by PH. The diagnostic accuracy to predict the LN status based on the SN concept by histological examination was 100%. The concordance rate between the OSNA assay and the PH and IH were 0.970 and 0.981 respectively. Discordant results between PH and OSNA assay were observed in 13 LNs. The sensitivity and specificity of the OSNA assay compared with those of PH were 0.636, and 0.988, and compared with those of IH were 0.800, and 0.995. Conclusion: Our results suggest that the OSNA assay is a useful and convenient tool for the intraoperative detection of SN metastasis in early gastric cancer patients.

Original languageEnglish
JournalGastric Cancer
DOIs
Publication statusAccepted/In press - 2019 Jan 1

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Nucleic Acids
Stomach Neoplasms
Lymph Nodes
Gastrectomy
Neoplasm Metastasis
cyhalothrin
Prospective Studies
Sensitivity and Specificity

Keywords

  • Gastrectomy
  • Gastric cancer
  • Histopathology
  • OSNA assay
  • Sentinel node mapping

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology
  • Cancer Research

Cite this

Utility of the one-step nucleic acid amplification assay in sentinel node mapping for early gastric cancer patients. / Shimada, Ayako; Takeuchi, Hiroya; Nishi, Tomohiko; Mayanagi, Shuhei; Fukuda, Kazumasa; Suda, Koichi; Nakamura, Rieko; Wada, Norihito; Kawakubo, Hirofumi; Nakahara, Tadaki; Kameyama, Kaori; Kitagawa, Yuko.

In: Gastric Cancer, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "Background: To safely perform minimized gastrectomy based on sentinel node (SN) concept for early gastric cancer patients, intraoperative diagnostic accuracy is indispensable. This study aimed to evaluate the clinical utility of the one-step nucleic acid amplification (OSNA) assay in the intraoperative diagnosis of SN metastasis in early gastric cancer patients compared with that of histopathological examination. Methods: We conducted a prospective study using the OSNA assay for 43 patients with cT1N0M0 gastric cancer undergoing gastrectomy with SN mapping. All the SNs and selected non-SNs were examined by routine histopathological diagnosis, and the OSNA assay. Results: We performed permanent histopathology (PH) in 1732 lymph nodes (LNs) (286 SNs and 1446 non-SNs) obtained from 43 patients. We also evaluated 439 LNs (286 SNs and 153 non-SNs) with the OSNA assay in addition to PH. Intraoperative histopathology (IH) was performed in 214 LNs (213 SNs and 1 non-SN). PH revealed LN metastasis in 6 patients (14{\%}), all of whom showed positive SNs by PH. The diagnostic accuracy to predict the LN status based on the SN concept by histological examination was 100{\%}. The concordance rate between the OSNA assay and the PH and IH were 0.970 and 0.981 respectively. Discordant results between PH and OSNA assay were observed in 13 LNs. The sensitivity and specificity of the OSNA assay compared with those of PH were 0.636, and 0.988, and compared with those of IH were 0.800, and 0.995. Conclusion: Our results suggest that the OSNA assay is a useful and convenient tool for the intraoperative detection of SN metastasis in early gastric cancer patients.",
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author = "Ayako Shimada and Hiroya Takeuchi and Tomohiko Nishi and Shuhei Mayanagi and Kazumasa Fukuda and Koichi Suda and Rieko Nakamura and Norihito Wada and Hirofumi Kawakubo and Tadaki Nakahara and Kaori Kameyama and Yuko Kitagawa",
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T1 - Utility of the one-step nucleic acid amplification assay in sentinel node mapping for early gastric cancer patients

AU - Shimada, Ayako

AU - Takeuchi, Hiroya

AU - Nishi, Tomohiko

AU - Mayanagi, Shuhei

AU - Fukuda, Kazumasa

AU - Suda, Koichi

AU - Nakamura, Rieko

AU - Wada, Norihito

AU - Kawakubo, Hirofumi

AU - Nakahara, Tadaki

AU - Kameyama, Kaori

AU - Kitagawa, Yuko

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: To safely perform minimized gastrectomy based on sentinel node (SN) concept for early gastric cancer patients, intraoperative diagnostic accuracy is indispensable. This study aimed to evaluate the clinical utility of the one-step nucleic acid amplification (OSNA) assay in the intraoperative diagnosis of SN metastasis in early gastric cancer patients compared with that of histopathological examination. Methods: We conducted a prospective study using the OSNA assay for 43 patients with cT1N0M0 gastric cancer undergoing gastrectomy with SN mapping. All the SNs and selected non-SNs were examined by routine histopathological diagnosis, and the OSNA assay. Results: We performed permanent histopathology (PH) in 1732 lymph nodes (LNs) (286 SNs and 1446 non-SNs) obtained from 43 patients. We also evaluated 439 LNs (286 SNs and 153 non-SNs) with the OSNA assay in addition to PH. Intraoperative histopathology (IH) was performed in 214 LNs (213 SNs and 1 non-SN). PH revealed LN metastasis in 6 patients (14%), all of whom showed positive SNs by PH. The diagnostic accuracy to predict the LN status based on the SN concept by histological examination was 100%. The concordance rate between the OSNA assay and the PH and IH were 0.970 and 0.981 respectively. Discordant results between PH and OSNA assay were observed in 13 LNs. The sensitivity and specificity of the OSNA assay compared with those of PH were 0.636, and 0.988, and compared with those of IH were 0.800, and 0.995. Conclusion: Our results suggest that the OSNA assay is a useful and convenient tool for the intraoperative detection of SN metastasis in early gastric cancer patients.

AB - Background: To safely perform minimized gastrectomy based on sentinel node (SN) concept for early gastric cancer patients, intraoperative diagnostic accuracy is indispensable. This study aimed to evaluate the clinical utility of the one-step nucleic acid amplification (OSNA) assay in the intraoperative diagnosis of SN metastasis in early gastric cancer patients compared with that of histopathological examination. Methods: We conducted a prospective study using the OSNA assay for 43 patients with cT1N0M0 gastric cancer undergoing gastrectomy with SN mapping. All the SNs and selected non-SNs were examined by routine histopathological diagnosis, and the OSNA assay. Results: We performed permanent histopathology (PH) in 1732 lymph nodes (LNs) (286 SNs and 1446 non-SNs) obtained from 43 patients. We also evaluated 439 LNs (286 SNs and 153 non-SNs) with the OSNA assay in addition to PH. Intraoperative histopathology (IH) was performed in 214 LNs (213 SNs and 1 non-SN). PH revealed LN metastasis in 6 patients (14%), all of whom showed positive SNs by PH. The diagnostic accuracy to predict the LN status based on the SN concept by histological examination was 100%. The concordance rate between the OSNA assay and the PH and IH were 0.970 and 0.981 respectively. Discordant results between PH and OSNA assay were observed in 13 LNs. The sensitivity and specificity of the OSNA assay compared with those of PH were 0.636, and 0.988, and compared with those of IH were 0.800, and 0.995. Conclusion: Our results suggest that the OSNA assay is a useful and convenient tool for the intraoperative detection of SN metastasis in early gastric cancer patients.

KW - Gastrectomy

KW - Gastric cancer

KW - Histopathology

KW - OSNA assay

KW - Sentinel node mapping

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