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一步核酸扩增与超分期在子宫内膜癌患者前哨淋巴结转移检测中的比较

One-step nucleic acid amplification vs ultrastaging in the detection of sentinel lymph node metastasis in endometrial cancer patients.

作者信息

Kosťun Jan, Pešta Martin, Sláma Jiří, Slunéčko Robert, Vlasák Pavel, Bouda Jiří, Novotný Zdeněk, Topolčan Ondřej, Kučera Radek, Kulda Vlastimil, Houfková Kateřina, Berezovskiy Denis, Bartáková Alena, Presl Jiří

机构信息

Department of Gynaecology and Obstetrics, University Hospital Pilsen, Charles University, Prague, Czech Republic.

Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.

出版信息

J Surg Oncol. 2019 Mar;119(3):361-369. doi: 10.1002/jso.25322. Epub 2018 Dec 3.

Abstract

BACKGROUND AND OBJECTIVES

Utilisation of the one-step nucleic acid amplification (OSNA) molecular biology method for the detection of the metastatic involvement of sentinel lymph nodes (SLNs) in endometrial cancer (EC) patients. A comparison with histopathological ultrastaging and a description of the clinical consequences.

METHODS

Surgically treated EC patients underwent detection of SLNs. Nodes greater than 5 mm were cut into sections 2-mm thick parallel to the short axis of the node. Odd sections were examined according to the OSNA method, while even ones according to an appropriate ultrastaging protocol. Nodes less than or equal to 5 mm were cut into halves along the longitudinal axis with one half examined according to the OSNA method and the other half by ultrastaging.

RESULTS

Fifty-eight patients were included and 135 SLNs were acquired. Both ultrastaging and OSNA agreed on 116 results. According to the OSNA method, 20.69% more patients were classified into International Federation of Gynecology and Obstetrics (FIGO) stage III. When comparing the results of the OSNA method to the conclusions of ultrastaging as a reference method, sensitivity of 90.9%, specificity of 85.5% and concordance of 85.9% were attained.

CONCLUSIONS

The results of the OSNA method showed a higher frequency of detection of micrometastases and included 20.69% more patients into FIGO stage III.

摘要

背景与目的

采用一步核酸扩增(OSNA)分子生物学方法检测子宫内膜癌(EC)患者前哨淋巴结(SLN)的转移情况。与组织病理学超分期进行比较并描述临床后果。

方法

对接受手术治疗的EC患者进行SLN检测。将直径大于5mm的淋巴结沿短轴切成2mm厚的切片。奇数切片按OSNA方法检查,偶数切片按适当的超分期方案检查。直径小于或等于5mm的淋巴结沿纵轴切成两半,一半按OSNA方法检查,另一半进行超分期检查。

结果

纳入58例患者,共获取135个SLN。超分期和OSNA在116个结果上一致。根据OSNA方法,多20.69%的患者被归类为国际妇产科联盟(FIGO)III期。将OSNA方法的结果与作为参考方法的超分期结果进行比较时,灵敏度为90.9%,特异性为85.5%,一致性为85.9%。

结论

OSNA方法的结果显示微转移检测频率更高,且多20.69%的患者被纳入FIGO III期。

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