title: The diagnostic value of one-step nucleic acid amplification (OSNA) for sentinel lymph nodes in colon cancer patients.
abstract: BACKGROUND
  Lymph node status in colon cancer is critical for prognosis estimation and treatment allocation. The purpose of this study was to compare the performance of one-step nucleic acid amplification (OSNA) through detection of cytokeratin 19 mRNA levels with routine pathological examination (RP) and multilevel fine pathological examination (FP) in sentinel lymph nodes (SLN), detected using the ex vivo SLN mapping (SLNM) procedure, in presurgically defined nonmetastatic colon cancer patients.
  
  
  METHODS
  In this prospective study, 325 SLNs of 128 patients from the Jeroen Bosch Hospital in 's-Hertogenbosch and the Leiden University Medical Center were investigated by RP (H&E), FP (H&E and Keratin Pan immunohistochemical staining), and OSNA. The SLNs were harvested by the SLNM procedure, using Patent blue or Indocyanine green. SLNs were divided and separate parts were used for RP, FP, and the OSNA assay.
  
  
  RESULTS
  The diagnostic value of OSNA was 82.1 and 100 % for both FP and combined method (OSNA and FP) compared with RP. An upstaging rate of 20.2 % was obtained with the use of OSNA only and 36.4 % with the use of FP only. An upstaging rate of 46.5 % was obtained by combining the two methods together.
  
  
  CONCLUSIONS
  OSNA and FP appeared to be promising tools for the detection of lymph node micro- and macrometastases in SLNs after SLNM. The performances of OSNA and FP in this study were superior to RP. Because OSNA allows analysis of the whole lymph node, sampling bias can be avoided. OSNA therefore may improve tumor staging.
authors.affiliation: Department of Surgery, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: F J
authors.initials: FJ
authors.lastname: Vogelaar
authors.forename: M S
authors.initials: MS
authors.lastname: Reimers
authors.forename: R L A
authors.initials: RL
authors.lastname: van der Linden
authors.forename: J C
authors.initials: JC
authors.lastname: van der Linden
authors.forename: V T H B M
authors.initials: VT
authors.lastname: Smit
authors.forename: D J
authors.initials: DJ
authors.lastname: Lips
authors.forename: C J H
authors.initials: CJ
authors.lastname: van de Velde
authors.forename: K
authors.initials: K
authors.lastname: Bosscha
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics*; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053539:Keratin-19 / Q000235:genetics*; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D009367:Neoplasm Staging; D021141:Nucleic Acid Amplification Techniques; D011379:Prognosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics; D012334:RNA, Neoplasm / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction; D020133:Reverse Transcriptase Polymerase Chain Reaction; D021701:Sentinel Lymph Node Biopsy
chemical_list: D014408:Biomarkers, Tumor; D053539:Keratin-19; D012333:RNA, Messenger; D012334:RNA, Neoplasm