title: Comparison of the Diagnostic Value Between Real-Time Reverse Transcription-Polymerase Chain Reaction Assay and Histopathologic Examination in Sentinel Lymph Nodes for Patients With Gastric Carcinoma.
abstract: OBJECTIVE
  Sentinel lymph node (SLN)-based diagnosis in gastric cancers has shown varied sensitivities and false-negative rates in several studies. Application of the reverse transcription-polymerase chain reaction (RT-PCR) in SLN diagnosis has recently been proposed.
  
  
  METHODS
  A total of 155 SLNs from 65 patients with cT1-2, N0 gastric cancer were examined. The histopathologic results were compared with results obtained by real-time RT-PCR for detecting molecular RNA (mRNA) of cytokeratin (CK)19, carcinoembryonic antigen (CEA), and CK20.
  
  
  RESULTS
  The sensitivity and specificity of the multiple marker RT-PCR assay standardized against the results of the postoperative histological examination were 0.778 (95% confidence interval [CI], 0.577-0.914) and 0.781 (95% CI, 0.700-0.850), respectively. In comparison, the sensitivity and specificity of intraoperative diagnosis were 0.819 (95% CI, 0.619-0.937) and 1.000 (95% CI, 0.972-1.000), respectively. The positive predictive value of the multiple-marker RT-PCR assay was 0.355 (95% CI, 0.192-0.546) for predicting non-SLN metastasis, which was lower than that of intraoperative diagnosis (0.813, 95% CI, 0.544-0.960).
  
  
  CONCLUSIONS
  The real-time RT-PCR assay could detect SLN metastasis in gastric cancer. However, the predictive value of the real-time RT-PCR assay was lower than that of precise histopathologic examination and did not outweigh that of our intraoperative SLN diagnosis.
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN. From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors.forename: Yoonjin
authors.initials: Y
authors.lastname: Kwak
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors.forename: Soo Kyung
authors.initials: SK
authors.lastname: Nam
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors.forename: Eun
authors.initials: E
authors.lastname: Shin
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Ahn
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors.forename: Hee Eun
authors.initials: HE
authors.lastname: Lee
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors.forename: Do Joong
authors.initials: do J
authors.lastname: Park
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
authors.forename: Woo Ho
authors.initials: WH
authors.lastname: Kim
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN. hye2@snu.ac.kr hhkim@snubh.org.
authors.forename: Hyung-Ho
authors.initials: HH
authors.lastname: Kim
authors.affiliation: From the Departments of Pathology and Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea; and Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN. hye2@snu.ac.kr hhkim@snubh.org.
authors.forename: Hye Seung
authors.initials: HS
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D002272:Carcinoembryonic Antigen / Q000032:analysis / Q000096:biosynthesis; D005260:Female; D006801:Humans; D053539:Keratin-19 / Q000032:analysis / Q000096:biosynthesis; D053554:Keratin-20 / Q000032:analysis / Q000096:biosynthesis; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D000071036:Sentinel Lymph Node / Q000473:pathology*; D013274:Stomach Neoplasms / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D053539:Keratin-19; D053554:Keratin-20
keywords: Gastric cancer; Real-time reverse transcription-polymerase chain reaction assays; Sentinel lymph node