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Meta-Analysis
. 2025 Jun 11;410(1):184.
doi: 10.1007/s00423-025-03742-4.

Systematic review and meta-analysis of diagnostic accuracy of one-step nucleic acid amplification for lymph node metastases of papillary thyroid carcinoma

Maria Magdalena Llompart-Coll  1 , Paula Domínguez-Garijo  1 , Martí Manyalich-Blasi  2 , Gemma Domènech-Gómez  3   4 , Iria Perales-Galan  3   4 , David Saavedra-Pérez  1   4 , Maria Teresa Rodrigo  5   4 , Sergi Vidal-Sicart  6   4 , Miguel Pera-Roman  1   4 , Oscar Vidal-Pérez  1   4
Affiliations
Meta-Analysis

Systematic review and meta-analysis of diagnostic accuracy of one-step nucleic acid amplification for lymph node metastases of papillary thyroid carcinoma

Maria Magdalena Llompart-Coll et al. Langenbecks Arch Surg. .

Abstract

Purpose: To evaluate the diagnostic accuracy and detection rate of lymph node metastases (LNM) in Papillary Thyroid Carcinoma (PTC) using the One-Step Nucleic Acid Amplification (OSNA) technique compared to conventional pathological methods.

Methods: A systematic search was conducted in PubMed, The Cochrane Library, Scopus, and Web of Science from May 1, 2023, to June 30, 2023, for studies published from January 1, 2005, to April 30, 2023. Observational studies assessing OSNA for LNM in PTC patients were included. Two independent reviewers performed study selection, record screening, data extraction, and quality assessment using QUADAS-2. Meta-analysis was conducted with Posit software (RStudio).

Results: Seven studies (2014-2021) involving 1,424 lymph nodes from 207 PTC patients were analyzed. The pooled sensitivity, specificity, and AUC of OSNA for detecting LNM were 0.905 (95% CI 0.838-0.946), 0.884 (95% CI 0.834-0.921), and 0.848, respectively.

Discussion: OSNA shows promising diagnostic accuracy compared to conventional pathological methods, with the potential to improve real-time lymphatic staging and aid intraoperative decision-making. Limitations include study heterogeneity and a lack of randomized controlled trials, affecting generalizability. Further research is needed to validate the long-term benefits of OSNA in clinical practice.

Keywords: Carcinoma, papillary; Lymphatic metastasis; Meta-analysis; Nucleic acid amplification techniques; Systematic review; Thyroid neoplasms.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Conflicts of interest: Authors declare to have no known conflicts of interest related to the present review.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram of the study selection process
Fig. 2
Fig. 2
QUADAS-2 Domain proportion analysis. Proportion of studies with low, high, and unclear bias and applicability concerns, respectively
Fig. 3
Fig. 3
Forest plots of pooled sensitivity and specificity
Fig. 4
Fig. 4
Forest plots of pooled positive and negative likelihood ratios
Fig. 5
Fig. 5
Forest plots of pooled diagnostic odds ratio (DOR)
Fig. 6
Fig. 6
Summary receiver operating characteristics (SROC) curve
See this image and copyright information in PMC

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