One-step nucleic acid amplification in sentinel lymph node metastasis of early cervical cancer
10.12025/j.issn.1008-6358.2023.20230562
- VernacularTitle:一步核酸扩增法检测早期宫颈癌前哨淋巴结转移的效果
- Author:
Li-Ping JIANG
1
;
Hai-Xia CHEN
;
Min ZHOU
;
Xu-Zhen WANG
;
Hua ZHAO
;
Shao-Jie ZHAO
Author Information
1. 江南大学附属妇产医院妇科,无锡 214002
- Keywords:
cervical cancer;
sentinel lymph node;
one-step nucleic acid amplification;
micrometastasis
- From:
Chinese Journal of Clinical Medicine
2023;30(6):946-952
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate effect of the one-step nucleic acid amplification(OSNA)method on detecting sentinel lymph node(SLN)metastasis in early cervical cancer,and its predictive value for non-SLN(nSLN)metastasis.Methods 68 patients with early cervical cancer were prospectively included,and SLN tissue specimens were collected during operation.Systematic pelvic lymph node dissection was performed in all patients.Each SLN was divided into two parts during operation:one was tested by OSNA,and other was underwent frozen section(FS).The results of postoperative pathological examination were used as the gold standard for diagnosis.The consistency,specificity and sensitivity of OSNA,FS and postoperative pathological results were compared in the evaluation of micrometastasis(MM)and macrometastasis(MC),and the sensitivity between OSNA and FS were compared.The pelvic nSLN rate in patients with different positive SLN number detected by OSNA.Results 130 SLNs were successfully detected in 68 patients during the operation,including 43 patients with 1 SLN,22 patients with 2 SLNs,and 3 patients with more than 2 SLNs,with an average of 1.9 SLNs per patient.The postoperative H-E stain and IHC detected 26(20.0%)positive SLNs,including 13 MC and 13 MM.OSNA detected 29(22.3%)positive SLN,including 13 MC and 16 MM,and 4 were false positive.Among 101 negative SLNs detected by OSNA,1 was found to be positive for MM by postoperative pathological examination.The specificity,sensitivity,negative predictive value and positive predictive value of OSNA for SLN metastasis were 96.2%,96.2%,99.0%and 86.2%,respectively(P=0.375)and its consistency with postoperative pathological detection was good(Kappa value= 0.885).The specificity,sensitivity,negative predictive value and positive predictive value of FS for SLN metastasis were 100%,61.5%,91.2%and 100%,respectively(P=0.002),and its consistency with postoperative pathological detection was general(Kappa value= 0.719).For MC SLN,the sensitivity of OSNA detection was 100%,and that of FS detection was 100%;for MM SLN,the sensitivity of OSNA detection was 92.3%,and that of FS was 23.1%(P=0.030).Compared with patients with 1 positive SLN detected by OSNA,the patients proportion of＞1 positive SLNs detected by OSNA was higher in patients with pelvic nSLN(77.8%vs 22.2%,P=0.041).Postoperative pathological results showed that the patients with positive SLN detected by OSNA had worse tumor differentiation,higher tumor proliferation index,and lymphatic vessel invasion.Conclusions The OSNA detection is simple and rapid,has similar sensitivity with postoperative pathological detection for SLN metastases,which is higher than FS,so it could be used as a new method for rapid intraoperative diagnosis of cervical cancer SLN metastases in patiehts with early cervical cancer.
