Dell'Orto Patrizia, Biasi Maria Olivia, Del Curto Barbara, Zurrida Stefano, Galimberti Viviana, Viale Giuseppe
Department of Pathology and Laboratory Medicine, European Institute of Oncology, Milan, Italy.
Breast Cancer Res Treat. 2006 Jul;98(2):185-90. doi: 10.1007/s10549-005-9148-x. Epub 2006 Mar 15.
The aim of the study was to assess the accuracy of a real-time quantitative RT-PCR (qRT-PCR) assay for mammaglobin 1 mRNA in the detection of metastatic breast cancer in axillary sentinel lymph nodes (SLN), comparing the results with those of qualitative RT-PCR assays and of an extensive histopathological examination. A retrospective series of 81 SLN from 72 patients and a validation series of 61 SLN from 61 patients were evaluated. In the retrospective series, the qRT-PCR assay was positive for 23 (28.4%) of the 81 SLN. The overall concordance with histopathology was 93.8%, with a sensitivity of 90.9%, a specificity of 94.9%, a positive predictive value (PPV) of 87% and a negative predictive value (NPV) of 96.6%. In the same series, qualitative RT-PCR showed an overall concordance with histopathology of 86.4%, a sensitivity of 72.7%, a specificity of 91.5%, a PPV of 76.2% and a NPV of 90%. In the validation series, including 23 patients with pure in situ carcinoma, the real-time qRT-PCR assay showed an overall concordance with the histopathologic findings of 93.4%, with a sensitivity of 75.0%, a specificity of 94.7%, a PPV of 50.0% and a NPV of 98.2%. We conclude that real-time qRT-PCR assays for mammaglobin 1 are more sensitive and specific that qualitative RT-PCR assays for the detection of metastatic breast carcinoma in axillary SLN, but it should not be regarded as a possible substitute for an extensive histopathological scrutiny of the SLN in the clinical practice.
本研究的目的是评估一种用于检测乳腺珠蛋白1 mRNA的实时定量逆转录聚合酶链反应（qRT-PCR）检测法在腋窝前哨淋巴结（SLN）转移性乳腺癌检测中的准确性，并将结果与定性逆转录聚合酶链反应检测法和广泛的组织病理学检查结果进行比较。对来自72例患者的81个SLN的回顾性系列和来自61例患者的61个SLN的验证系列进行了评估。在回顾性系列中，81个SLN中有23个（28.4%）的qRT-PCR检测呈阳性。与组织病理学的总体一致性为93.8%，敏感性为90.9%，特异性为94.9%，阳性预测值（PPV）为87%，阴性预测值（NPV）为96.6%。在同一系列中，定性RT-PCR显示与组织病理学的总体一致性为86.4%，敏感性为72.7%，特异性为91.5%，PPV为76.2%，NPV为90%。在包括23例纯原位癌患者的验证系列中，实时qRT-PCR检测显示与组织病理学结果的总体一致性为93.4%，敏感性为75.0%，特异性为94.7%，PPV为50.0%，NPV为98.2%。我们得出结论，用于乳腺珠蛋白1的实时qRT-PCR检测法在检测腋窝SLN转移性乳腺癌方面比定性RT-PCR检测法更敏感、更特异，但在临床实践中不应将其视为对SLN进行广泛组织病理学检查的可能替代方法。
