Kosťun Jan, Ismail Khaled M, Pešta Martin, Slunečko Robert, Stráník Petr, Smoligová Vendula, Presl Jiří
Department of Gynaecology and Obstetrics, University Hospital Pilsen and Faculty of Medicine in Pilsen, Charles University, Plzeň-Lochotín, Czech Republic.
Department of Gynaecology and Obstetrics and Biomedical Center, University Hospital Pilsen and Faculty of Medicine in Pilsen, Charles University, Plzeň-Lochotín, Czech Republic.
Cancer Rep (Hoboken). 2024 Dec;7(12):e70082. doi: 10.1002/cnr2.70082.
Endometrial cancer (EC) is the most common gynecological cancer worldwide and its incidence is rising. The cornerstone of its management is surgical treatment with nodal staging. A monocentric study investigating the potential of the molecular biology method of one-step nucleic acid amplification (OSNA) in sentinel lymph node (SLN) analysis was conducted at our institution between April 2016 and January 2018. Histopathological ultrastaging was used as the reference standard for SLN examination and OSNA as the index test. The aim of this study was to assess the long-term outcome of patients with discordant SLN and OSNA results. To our knowledge, this is the first study exploring this issue.
Patients were followed in line with the current ESMO/ESGO/ESTRO recommendations. The institutional electronic database was retrospectively searched for patients' follow-up data from April 2016 till March 2023. Only patients who provided a written valid consent and had a positive OSNA and negative ultrastaging of their SLN analysis were included in the study. The primary endpoint was the retrospective analysis of their clinical outcome. Data from 58 patients enrolled into our previous study were reviewed and 12 discordant patients who met the inclusion criteria for this study were identified. The median follow-up was 83 months. Disease recurrence was detected in 3 (25%) patients, two of these were nodal and both patients died. One patient had a solitary lung metastasis which was surgically treated, and the patient was disease-free during the whole study period.
The recurrence rate of patients included in the study was in the intermediate-high and high-risk group range, and hence, higher than expected based on ultrastaging results. Furthermore, benign epithelial inclusions do not seem to adversely affect OSNA SLN analysis in EC patients.
子宫内膜癌（EC）是全球最常见的妇科癌症，其发病率正在上升。其治疗的基石是进行淋巴结分期的手术治疗。2016年4月至2018年1月期间，我们机构开展了一项单中心研究，调查一步核酸扩增（OSNA）这种分子生物学方法在前哨淋巴结（SLN）分析中的潜力。组织病理学超分期用作SLN检查的参考标准，OSNA用作指标检测。本研究的目的是评估SLN与OSNA结果不一致的患者的长期结局。据我们所知，这是第一项探索该问题的研究。
患者按照当前欧洲肿瘤内科学会（ESMO）/欧洲妇科肿瘤学会（ESGO）/欧洲放射肿瘤学会（ESTRO）的建议进行随访。对机构电子数据库进行回顾性搜索，以获取2016年4月至2023年3月期间患者的随访数据。本研究仅纳入提供了书面有效同意书且OSNA结果为阳性而SLN分析的超分期结果为阴性的患者。主要终点是对其临床结局进行回顾性分析。对纳入我们之前研究的58例患者的数据进行了审查，确定了12例符合本研究纳入标准的不一致患者。中位随访时间为83个月。3例（25%）患者检测到疾病复发，其中2例为淋巴结转移，这2例患者均死亡。1例患者有孤立性肺转移，接受了手术治疗，该患者在整个研究期间无疾病。
本研究纳入患者的复发率处于中高风险组范围，因此高于基于超分期结果的预期。此外，良性上皮包涵体似乎不会对EC患者的OSNA SLN分析产生不利影响。
