title: One-step nucleic acid amplification for detecting lymph node metastasis of head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  Lymph node stage is an important prognostic factor in head and neck squamous cell carcinoma (HNSCC). We previously reported the clinical usefulness of sentinel lymph node biopsy diagnosed by genetic analysis using quantitative RT-PCR. However, this method takes about 3h. In this study, we attempted to develop a more efficient method for the intraoperative genetic detection of lymph node metastasis in HNSCC.
  
  
  METHODS
  A total of 312 lymph nodes (65 patients) were diagnosed by the one-step nucleic acid amplification (OSNA) method using GD-100. OSNA consists of a short homogenization step followed by amplification of cytokeratin 19 (CK19) mRNA directly from the lysate. Each lymph node was divided into two to diagnose metastasis. One half was used for the OSNA assay, and the other was subjected to semi-serial sectioning, sliced at 200-μm intervals and examined by H&E and cytokeratin AE1/AE3 immunohistochemical staining. The accuracy of OSNA assay was evaluated based on histopathological diagnosis.
  
  
  RESULTS
  Sixty-one of 312 lymph nodes were pathologically metastasis-positive. The overall concordance rate between the OSNA assay using breast cancer criteria and histopathology was 94.2%. The optimal cut-off for the copy number of CK19 mRNA in assessing lymph node metastasis of HNSCC was 300 copies/μl, which had the highest diagnostic accuracy (95.2%). The OSNA assay can be completed within 30 min.
  
  
  CONCLUSIONS
  The OSNA assay, which shows high sensitivity and specificity, suggests the possibility to be used as a novel tool for the genetic detection of lymph node metastasis in HNSCC patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Goda
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan. Electronic address: nakako@m.ehime-u.ac.jp.
authors.forename: Koh-Ichi
authors.initials: KI
authors.lastname: Nakashiro
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Oka
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Wakisaka
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Hato
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Hyodo
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hamakawa
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000378:metabolism / Q000556:secondary*; D006258:Head and Neck Neoplasms / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007432:Intraoperative Period; D053539:Keratin-19 / Q000378:metabolism; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D021141:Nucleic Acid Amplification Techniques / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D053539:Keratin-19