Accurate and rapid novel genetic diagnosis for detection of sentinel lymph node metastasis in breast cancer patients.
BACKGROUND
The transcription-reverse transcription concerted reaction (TRC) test is a novel molecular-based procedure, which can assess nodal metastasis accurately and quickly. We examined the usefulness of the TRC test with a double marker, cytokeratin 19 (CK19) and carcinoembryonic antigen (CEA) mRNA, to detect sentinel lymph nodes (SLN) metastasis in breast cancer patients.


METHODS
A total of 264 SLNs from 131 breast cancer patients were assigned to a training set (109 SLNs from 50 patients) and validation set (155 SLNs from 81 patients). Cytokeratin 19 and CEA mRNA were detected by TRC tests, and the sensitivity and specificity of the SLN metastasis between the TRC and histology cohorts were compared.


RESULTS
Mean copy numbers of CK19 and CEA by TRC tests were increased according to the metastatic size. In the training set, TRC test showed 100% sensitivity, specificity and concordance rates against the permanent histopathology test. In the validation set, sensitivity was 97.1%, specificity was 99.2% and the concordance rate was 99.4%.


CONCLUSIONS
Our results showed that the detection of CK19 and CEA mRNA using the TRC test is, an accurate and rapid method for detection of SLN metastasis and can be applied as an intraoperative molecular diagnosis in breast cancer patients.
Department of Surgery, Teikyo University School of Medicine, Tokyo 173-0003, Japan. iinuma@med.teikyo-u.ac.jp
H
H
Iinuma
J
J
Tamura
D
D
Omoto
N
N
Kamo
S
S
Ohnaka
Y
Y
Mitoma
Y
Y
Miyazawa
K
K
Okinaga
T
T
Imamura
R
R
Fukushima
T
T
Watanabe
T
T
Ikeda
D001365:Axilla / Q000473:pathology; D014408:Biomarkers, Tumor / Q000235:genetics; D001943:Breast Neoplasms / Q000473:pathology*; D002272:Carcinoembryonic Antigen / Q000235:genetics; D056915:DNA Copy Number Variations; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D053539:Keratin-19 / Q000235:genetics; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D012333:RNA, Messenger; D048348:Reverse Transcription; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D012333:RNA, Messenger