Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Aug 29;5(1):60-66.
doi: 10.1002/ags3.12392. eCollection 2021 Jan.

The advantage of one-step nucleic acid amplification for the diagnosis of lymph node metastasis in colorectal cancer patients

Yukiharu Hiyoshi  1 , Takashi Akiyoshi  1 , Yosuke Fukunaga  1
Affiliations
Review

The advantage of one-step nucleic acid amplification for the diagnosis of lymph node metastasis in colorectal cancer patients

Yukiharu Hiyoshi et al. Ann Gastroenterol Surg. .

Abstract

Generally, the postoperative examination of lymph nodes (LNs) is based on a microscopic examination of one hematoxylin and eosin (HE)-stained slide; however, an examination of only one part of the LN might lead to incorrect staging of the tumor due to tissue allocation bias. Although multilevel sectioning and the use of immunohistochemistry (IHC) have improved the detection of micrometastases in LNs, this approach is laborious, time-consuming, and costly. A novel molecular technique for the detection of LN metastases of tumors, called one-step nucleic acid amplification (OSNA), is a rapid and semi-quantitative examination quantifying the number of cytokeratin 19 (CK-19) mRNA copies derived from a tumor. OSNA is already in clinical use for the diagnosis of LN metastasis in breast cancer patients; however, the use of OSNA is under investigation with promising results for colorectal cancer (CRC). The present review assessed recent studies on OSNA vs a histopathological examination and its implications for CRC staging and treatment. A total of 16 studies of OSNA in CRC yielded by a PubMed search were reviewed. Among them, seven studies evaluating the diagnostic performance revealed that OSNA had a high specificity (96.8%), high concordance rate (96.0%), and negative predictive value (98.6%) in a pooled assessment. In addition, four studies examining the utility of OSNA in sentinel LNs (SLNs) and two studies focusing on upstaging in pathologically node-negative CRC patients were also reviewed. Multicenter prospective studies with a large cohort of CRC patients are warranted to reveal the benefits of OSNA in the future.

Keywords: CK‐19; OSNA; colorectal cancer; lymph node metastasis; micrometastasis; sentinel lymph node.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: Authors declare no conflicts of interest or financial ties to disclosure. Author Contribution: Yukiharu Hiyoshi study conception design, Drafting the article. Takashi Akiyoshi study conception design. Yosuke Fukunaga study conception design.

References

    1. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300. - PubMed
    1. Goldstein NS. Lymph node recoveries from 2427 pT3 colorectal resection specimens spanning 45 years: recommendations for a minimum number of recovered lymph nodes based on predictive probabilities. Am J Surg Pathol. 2002;26:179–89. - PubMed
    1. Sloothaak D, Sahami S, van der Zaag‐Loonen HJ, van der Zaag ES, Tanis PJ, Bemelman WA, et al. The prognostic value of micrometastases and isolated tumour cells in histologically negative lymph nodes of patients with colorectal cancer: a systematic review and meta‐analysis. Eur J Surg Oncol. 2014;40:263–9. - PubMed
    1. Weitz J, Kienle P, Magener A, et al. Detection of disseminated colorectal cancer cells in lymph nodes, blood and bone marrow. Clin Cancer Res. 1999;5:1830–6. - PubMed
    1. Rahbari NN, Bork U, Motschall E, Thorlund K, Büchler MW, Koch M, et al. Molecular detection of tumor cells in regional lymph nodes is associated with disease recurrence and poor survival in node‐negative colorectal cancer: a systematic review and meta‐analysis. J Clin Oncol. 2012;30:60–70. - PubMed