Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Department of General Thoracic Surgery, Osaka Toneyama Medical Center, Osaka, Japan.
PLoS One. 2022 Mar 21;17(3):e0265603. doi: 10.1371/journal.pone.0265603. eCollection 2022.
The prognosis of non-small cell lung cancer greatly depends on the presence of lymph node metastasis, which limits the need for surgery and adjuvant therapy for advanced cancer. One-step nucleic acid amplification of cytokeratin19 (CK19) mRNA was used to detect lymph node metastasis. Automated Gene Amplification Detector RD-200 and the LYNOAMP CK19 gene amplification reagent as components of the new one-step nucleic acid amplification system, which has increased gene amplification efficiency by improving the reagent composition, have shorter preprocessing and measurement times than conventional systems. We aimed to compare the clinical performance of the new system with that of histopathology and the conventional system.
199 lymph nodes from 58 non-small cell lung cancer patients who underwent lymph node dissection were examined intraoperatively using the new system, conventional system, and histopathology.
Lymph node metastasis was diagnosed in 32, 42, and 44 patients using histopathological analysis, the new system, and the conventional system, respectively. Compared with histopathological analysis, the concordance rate, sensitivity, specificity, positive predictive value, and negative predictive value of the new system were 92.0%, 90.6%, 92.2%, 69.0%, and 98.1%, respectively, and compared with the conventional system, the values were 95.0%, 86.4%, 97.4%, 90.5%, and 96.2%, respectively.
The clinical performance of the new one-step nucleic acid amplification system in detecting lymph node metastasis of lung cancer is comparable to that of histopathology and the conventional system; its performance was sufficient for determining the appropriate clinical treatment. The new rapid system can be effectively utilized during lung cancer treatment intraoperatively and postoperatively.
非小细胞肺癌的预后在很大程度上取决于淋巴结转移的存在,这限制了晚期癌症手术和辅助治疗的需要。细胞角蛋白 19(CK19)mRNA 的一步法核酸扩增用于检测淋巴结转移。自动化基因扩增检测仪 RD-200 和 LYNOAMP CK19 基因扩增试剂作为新的一步法核酸扩增系统的组成部分,通过改进试剂组成提高了基因扩增效率,预处理和测量时间比传统系统更短。我们旨在比较新系统与组织病理学和传统系统的临床性能。
对 58 例接受淋巴结清扫术的非小细胞肺癌患者的 199 个淋巴结进行了术中检查,分别使用新系统、常规系统和组织病理学进行检查。
组织病理学分析、新系统和常规系统分别诊断 32、42 和 44 例患者的淋巴结转移。与组织病理学分析相比,新系统的一致性、敏感性、特异性、阳性预测值和阴性预测值分别为 92.0%、90.6%、92.2%、69.0%和 98.1%,与常规系统相比,分别为 95.0%、86.4%、97.4%、90.5%和 96.2%。
新的一步法核酸扩增系统检测肺癌淋巴结转移的临床性能与组织病理学和常规系统相当;其性能足以确定适当的临床治疗。新的快速系统可在肺癌治疗期间和术后有效利用。