title: Molecular Diagnosis for Nodal Metastasis in Endoscopically Managed Cervical Cancer: The Accuracy of the APTIMA Test to Detect High-risk Human Papillomavirus Messenger RNA in Sentinel Lymph Nodes.
abstract: To evaluate the feasibility and accuracy of a commercially available test to detect E6/E7 mRNA of 14 subtypes of high-risk HPVs (APTIMA; Hologic, Bedford, MA) in the sentinel lymph nodes of CC patients laparoscopically operated.
  
  
  
  Prospective pilot study.
  
  
  
  The study was conducted in the Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany.
  
  
  
  54 women with HPV-positive CC submitted to laparoscopic sentinel node biopsy alone or sentinel node biopsy followed by systematic pelvic and/or para-aortic endoscopic lymphadenectomy.
  
  
  
  All removed sentinel lymph nodes (SLNs) underwent sample collection by cytobrush for the APTIMA assay before frozen section.
  
  
  
  Results obtained with the HPV mRNA test were compared with the definitive histopathological analysis of the SLNs and additional lymph nodes removed.
  
  
  
  A total of 125 SLNs (119 pelvic and 6 paraaortic) were excised with a mean number of 2.3 SLNs per patient. Final histopathologic analysis confirmed nodal metastases in 10 SLNs from 10 different patients (18%). All the histologically confirmed metastatic lymph nodes were also HPV E6/E7 mRNA positive, resulting in a sensitivity of 100%. Four histologically free sentinel nodes were positive for HPV E6/E7 mRNA, resulting in a specificity of 96.4%.
  
  
  
  The HPV E6/E7 mRNA assay in the SLNs of patients with CC is feasible and highly accurate. The detection of HPV mRNA in 4 women with negative SLNs might denote a shift from microscopic identification of metastasis to the molecular level. The prognostic value of this findings awaits further verification.
authors.affiliation: Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany.
authors.forename: Christhardt
authors.initials: C
authors.lastname: Köhler
authors.affiliation: Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany.
authors.forename: Xin
authors.initials: X
authors.lastname: Le
authors.affiliation: Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany; Department of Obstetrics and Gynecology, Akdeniz University, Antalya, Turkey.
authors.forename: Nasuh Utku
authors.initials: NU
authors.lastname: Dogan
authors.affiliation: Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany.
authors.forename: Tatiana
authors.initials: T
authors.lastname: Pfiffer
authors.affiliation: Institute for Cytology and Dysplasia, Fürstenbergkarree, Berlin, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Schneider
authors.affiliation: Department of Radiooncology, University of Cologne, Cologne, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Marnitz
authors.affiliation: Institute for Pathology, MVZ Hanse Histologicum, Hamburg, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Bertolini
authors.affiliation: Department of Advanced Operative and Oncologic Gynecology, Asklepios Hospital, Hamburg, Germany. Electronic address: gdifavero@hotmail.com.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Favero
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D000328:Adult; D000368:Aged; D001011:Aorta; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D005260:Female; D005858:Germany; D061809:Human Papillomavirus DNA Tests / Q000379:methods*; D052163:Human papillomavirus 6 / Q000235:genetics; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D009367:Neoplasm Staging; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D010388:Pelvis; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D012333:RNA, Messenger / Q000378:metabolism*; D000071036:Sentinel Lymph Node / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D055815:Young Adult
chemical_list: D012333:RNA, Messenger
keywords: Cervical cancer; Endoscopic sentinel node biopsy; Human papillomavirus messenger RNA; Molecular diagnostic; Nodal metastasis