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Observational Study
. 2024 Dec 17;25(24):13489.
doi: 10.3390/ijms252413489.

Molecular Detection of Lymph Node Metastases with One-Step Nucleic Acid Amplification (OSNA) Pooling in Prostate Cancer: The POPCORN Study

Mercè Cuadras  1   2 , Maria E Semidey  3 , Jacques Planas  1   2 , Inés M de Torres  3   4 , Lucas Regis  1   2 , Ana Celma  1   2 , Enrique Trilla  1   2 , Santiago Ramón Y Cajal  3   4 , Rafael A Medina  5 , Belén Congregado  5 , David Marcilla  6 , Miguel A Japón  6 , Miguel Ramirez  7 , Ana Calatrava-Fons  8 , Asier Leivar  9 , María B Alonso  9 , Eugenia García  10 , Pilar González-Peramato  10 , Dario Vazquez-Martul  11 , Ángel Concha-López  12 , Venancio Chantada  11 , Francisco J Queipo  12 , José L Gago  13 , Cristina Carrato  14 , Rafael J Luque  15 , Juan Moreno-Jimenez  16 , Inmaculada Catalina-Fernández  17 , Cristina León  18 , Juan Morote  1   2
Affiliations
Observational Study

Molecular Detection of Lymph Node Metastases with One-Step Nucleic Acid Amplification (OSNA) Pooling in Prostate Cancer: The POPCORN Study

Mercè Cuadras et al. Int J Mol Sci. .

Abstract

Pelvic lymph node dissection (PLND) is the most accurate procedure for lymph node (LN) staging in prostate cancer (PCa) patients. LN sectioning and hematoxylin and eosin (H&E) staining of at least one slice remains the gold standard for LN evaluation, potentially leading to misdetection of small metastatic focus. Entire LN analysis is possible with One-Step Nucleic Acid Amplification (OSNA) by detecting cytokeratin 19 (CK19) mRNA as a surrogate for LN invasion. This study aimed to compare postoperative performance of OSNA pooling with conventional H&E staining for pathological LN detection in PCa patients. POPCORN was an observational, prospective, and multicenter study of patients with PCa who underwent PLND. Dissected LNs were analyzed by both methods. This study included 2503 LNs from 131 patients, showing no statistically significant differences in pathological LN detection. Concordance between methods was high (93.9%), as were specificity (96.6%) and negative predictive value (96.6%) of OSNA pooling. The measure of agreement (Cohen's Kappa [κ]) was 0.70. Only eight (6.1%) discordances were observed, including four misdetections from each method. Results showed a high concordance between OSNA pooling and H&E staining, suggesting that OSNA pooling may be a good alternative to H&E staining to detect LN metastases in PCa patients.

Keywords: OSNA; cytokeratin 19; hematoxylin and eosin staining; lymph node metastases; pelvic lymph node dissection; pooling; prostate cancer.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Receiver operating characteristic curves showing the discrimination ability of OSNA to identify lymph node metastases already diagnosed with H&E staining. Results are presented by patient (A) and sample tube (B). A threshold of 250 copies/μL of CK19 mRNA is used as a surrogate marker for LN metastasis in PCa, as outlined in the manufacturer’s manual.
Figure 2
Figure 2
Comparison of examination results for the presence of tumor cells using the H&E staining and OSNA pooling methods. A: H&E, hematoxylin and eosin; B: OSNA, One-Step Nucleic Acid Amplification.
Figure 3
Figure 3
Scatter plot representing CK19 mRNA levels in discordant cases. The green line marks the cut off of 250 copies/μL of CK19 mRNA, above which the case is considered positive or pathological. Note that the three discordant cases located below 160 copies/μL are represented in the minimum established detection value of OSNA. CK19, cytokeratin 19; H&E, hematoxylin and eosin; OSNA, One-Step Nucleic Acid Amplification.
Figure 4
Figure 4
Processing of lymph nodes for hematoxylin and eosin (H&E) staining and One-Step Nucleic Acid Amplification (OSNA) pooling analyses.
See this image and copyright information in PMC

References

    1. Abdollah F., Suardi N., Gallina A., Bianchi M., Tutolo M., Passoni N., Fossati N., Sun M., dell’Oglio P., Salonia A., et al. Extended Pelvic Lymph Node Dissection in Prostate Cancer: A 20-Year Audit in a Single Center. Ann. Oncol. 2013;24:1459–1466. doi: 10.1093/annonc/mdt120. - DOI - PubMed
    1. Winter A., Kneib T., Wasylow C., Reinhardt L., Henke R.P., Engels S., Gerullis H., Wawroschek F. Updated Nomogram Incorporating Percentage of Positive Cores to Predict Probability of Lymph Node Invasion in Prostate Cancer Patients Undergoing Sentinel Lymph Node Dissection. J. Cancer. 2017;8:2692–2698. doi: 10.7150/jca.20409. - DOI - PMC - PubMed
    1. Eggener S.E., Scardino P.T., Walsh P.C., Han M., Partin A.W., Trock B.J., Feng Z., Wood D.P., Eastham J.A., Yossepowitch O., et al. Predicting 15-Year Prostate Cancer Specific Mortality after Radical Prostatectomy. J. Urol. 2011;185:869–875. doi: 10.1016/j.juro.2010.10.057. - DOI - PMC - PubMed
    1. Joniau S., Briganti A., Gontero P., Gandaglia G., Tosco L., Fieuws S., Tombal B., Marchioro G., Walz J., Kneitz B., et al. Stratification of High-Risk Prostate Cancer into Prognostic Categories: A European Multi-Institutional Study. Eur. Urol. 2015;67:157–164. doi: 10.1016/j.eururo.2014.01.020. - DOI - PubMed
    1. Cheng L., Zincke H., Blute M.L., Bergstralh E.J., Scherer B., Bostwick D.G. Risk of Prostate Carcinoma Death in Patients with Lymph Node Metastasis. Cancer. 2001;91:66–73. doi: 10.1002/1097-0142(20010101)91:1<66::AID-CNCR9>3.0.CO;2-P. - DOI - PubMed

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