title: Concordance study between one-step nucleic acid amplification and morphologic techniques to detect lymph node metastasis in papillary carcinoma of the thyroid.
abstract: Tumor resection in papillary thyroid carcinoma (PTC) is often accompanied by lymph node (LN) removal of the central and lateral cervical compartments. One-step nucleic acid amplification (OSNA) is a polymerase chain reaction-based technique that quantifies cytokeratin 19 (CK19) messenger RNA copies. Our aim is to assess the value of OSNA in detection of LN metastases in PTC, in comparison with imprints and microscopic analysis of formalin-fixed, paraffin-embedded (FFPE) tissue. A total of 387 LNs from 37 patients were studied. From each half LN, 2 imprints were taken and analyzed with hematoxylin and eosin (H&E) and CK19 immunostaining. One half of the LN was submitted to OSNA and one half to FFPE processing and H&E and CK19 staining. For concordance analysis, every single LN was considered as a case. A group of 11 cases with discordant results between OSNA and H&E/CK19 FFPE sections were subjected to additional FFPE serial sectioning and H&E and CK19 staining. We found a high degree of concordance between the assays used, with sensitivities ranging from 0.81 to 0.95, and specificities ranging from 0.87 and 0.98. OSNA allowed upstaging of patients from pN0 to pN1, in comparison with standard pathologic analysis. Identification of a metastatic LN with more than 15000 CK19 messenger RNA copies predicted the presence of a second LN with macrometastasis (<5000 copies). In summary, the study shows that OSNA application in sentinel or suspicious LN may be helpful in assessing nodal status in PTC patients.
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, 37007, Spain.
authors.forename: Sofía
authors.initials: S
authors.lastname: del Carmen
authors.affiliation: Hospital Universitari Arnau de Vilanova de Lleida, IRB Lleida, Lleida, 25198, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Gatius
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, 37007, Spain.
authors.forename: Guzmán
authors.initials: G
authors.lastname: Franch-Arcas
authors.affiliation: Hospital Universitari Arnau de Vilanova de Lleida, IRB Lleida, Lleida, 25198, Spain.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Baena
authors.affiliation: Hospital Vall d'Hebron, VHIR, Barcelona, 08035, Spain.
authors.forename: Oscar
authors.initials: O
authors.lastname: Gonzalez
authors.affiliation: Hospital Vall d'Hebron, VHIR, Barcelona, 08035, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Zafon
authors.affiliation: Hospital Universitari Arnau de Vilanova de Lleida, IRB Lleida, Lleida, 25198, Spain.
authors.forename: Dolors
authors.initials: D
authors.lastname: Cuevas
authors.affiliation: Hospital Universitari Arnau de Vilanova de Lleida, IRB Lleida, Lleida, 25198, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Valls
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, 37007, Spain.
authors.forename: Angustias
authors.initials: A
authors.lastname: Pérez
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, 37007, Spain.
authors.forename: Mercedes
authors.initials: M
authors.lastname: Martinez
authors.affiliation: Hospital Universitari Arnau de Vilanova de Lleida, IRB Lleida, Lleida, 25198, Spain.
authors.forename: Susana
authors.initials: S
authors.lastname: Ros
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, 37007, Spain.
authors.forename: Carmen García
authors.initials: CG
authors.lastname: Macías
authors.affiliation: Hospital Vall d'Hebron, VHIR, Barcelona, 08035, Spain.
authors.forename: Carmela
authors.initials: C
authors.lastname: Iglesias
authors.affiliation: Hospital Universitari Arnau de Vilanova de Lleida, IRB Lleida, Lleida, 25198, Spain. Electronic address: fjmatiasguiu.lleida.ics@gencat.cat.
authors.forename: Xavier
authors.initials: X
authors.lastname: Matías-Guiu
authors.affiliation: Hospital Universitario de Salamanca, Salamanca, 37007, Spain. Electronic address: enrique.alava.sspa@juntadeandalucia.es.
authors.forename: Enrique
authors.initials: E
authors.lastname: de Álava
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000032:analysis; D002277:Carcinoma / Q000473:pathology*; D002291:Carcinoma, Papillary; D006801:Humans; D053539:Keratin-19 / Q000032:analysis*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D009367:Neoplasm Staging / Q000379:methods*; D016612:Paraffin Embedding; D016133:Polymerase Chain Reaction / Q000379:methods*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013194:Staining and Labeling; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D053539:Keratin-19
keywords: Lymph node; Metastasis; OSNA; Papillary carcinoma; Thyroid