Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre Study
Early-stage colorectal carcinoma (CRC)—pT1—is a therapeutic challenge and presents some histological features related to lymph node metastasis (LNM). A significant proportion of pT1 CRCs are treated surgically, resulting in a non-negligible surgical-associated mortality rate of 1.5–2%. Among these c...
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| Format: | Article |
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MDPI AG
2023-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/22/5481 |
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| author | Karmele Saez de Gordoa Maria Teresa Rodrigo-Calvo Ivan Archilla Sandra Lopez-Prades Alba Diaz Jordi Tarragona Isidro Machado Juan Ruiz Martín Diana Zaffalon Maria Daca-Alvarez Maria Pellisé Jordi Camps Miriam Cuatrecasas |
| author_facet | Karmele Saez de Gordoa Maria Teresa Rodrigo-Calvo Ivan Archilla Sandra Lopez-Prades Alba Diaz Jordi Tarragona Isidro Machado Juan Ruiz Martín Diana Zaffalon Maria Daca-Alvarez Maria Pellisé Jordi Camps Miriam Cuatrecasas |
| author_sort | Karmele Saez de Gordoa |
| collection | DOAJ |
| description | Early-stage colorectal carcinoma (CRC)—pT1—is a therapeutic challenge and presents some histological features related to lymph node metastasis (LNM). A significant proportion of pT1 CRCs are treated surgically, resulting in a non-negligible surgical-associated mortality rate of 1.5–2%. Among these cases, approximately 6–16% exhibit LNM, but the impact on survival is unclear. Therefore, there is an unmet need to establish an objective and reliable lymph node (LN) staging method to optimise the therapeutic management of pT1 CRC patients and to avoid overtreating or undertreating them. In this multicentre study, 89 patients with pT1 CRC were included. All histological features associated with LNM were evaluated. LNs were assessed using two methods, One-Step Nucleic Acid Amplification (OSNA) and the conventional FFPE plus haematoxylin and eosin (H&E) staining. OSNA is an RT-PCR-based method for amplifying CK19 mRNA. Our aim was to assess the performance of OSNA and H&E in evaluating LNs to identify patients at risk of recurrence and to optimise their clinical management. We observed an 80.9% concordance in LN assessment using the two methods. In 9% of cases, LNs were found to be positive using H&E, and in 24.7% of cases, LNs were found to be positive using OSNA. The OSNA results are provided as the total tumour load (TTL), defined as the total tumour burden present in all the LNs of a surgical specimen. In CRC, a TTL ≥ 6000 CK19 m-RNA copies/µL is associated with poor prognosis. Three patients had TTL > 6000 copies/μL, which was associated with higher tumour budding. The discrepancies observed between the OSNA and H&E results were mostly attributed to tumour allocation bias. We concluded that LN assessment with OSNA enables the identification of pT1 CRC patients at some risk of recurrence and helps to optimise their clinical management. |
| first_indexed | 2024-03-09T16:56:56Z |
| format | Article |
| id | doaj.art-aff712642c1c4885857f9080f6f92fd9 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T16:56:56Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-aff712642c1c4885857f9080f6f92fd92023-11-24T14:34:43ZengMDPI AGCancers2072-66942023-11-011522548110.3390/cancers15225481Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre StudyKarmele Saez de Gordoa0Maria Teresa Rodrigo-Calvo1Ivan Archilla2Sandra Lopez-Prades3Alba Diaz4Jordi Tarragona5Isidro Machado6Juan Ruiz Martín7Diana Zaffalon8Maria Daca-Alvarez9Maria Pellisé10Jordi Camps11Miriam Cuatrecasas12Pathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, SpainPathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, SpainPathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, SpainPathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, SpainPathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, SpainPathology Department, Hospital Arnau de Vilanova, 25198 Lleida, SpainPathology Department, Instituto Valenciano de Oncología, Hospital Quirón-Salud Valencia, University of Valencia, 46010 Valencia, SpainPathology Department, Virgen de la Salud Hospital, 45071 Toledo, SpainGastroenterology Department, Consorci Sanitari de Terrassa, 08227 Terrassa, SpainGastroenterology Department, Hospital Clinic, University of Barcelona, 08036 Barcelona, SpainAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, SpainAugust Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, SpainPathology Department, Centre of Biomedical Diagnosis (CDB), Hospital Clinic, 08036 Barcelona, SpainEarly-stage colorectal carcinoma (CRC)—pT1—is a therapeutic challenge and presents some histological features related to lymph node metastasis (LNM). A significant proportion of pT1 CRCs are treated surgically, resulting in a non-negligible surgical-associated mortality rate of 1.5–2%. Among these cases, approximately 6–16% exhibit LNM, but the impact on survival is unclear. Therefore, there is an unmet need to establish an objective and reliable lymph node (LN) staging method to optimise the therapeutic management of pT1 CRC patients and to avoid overtreating or undertreating them. In this multicentre study, 89 patients with pT1 CRC were included. All histological features associated with LNM were evaluated. LNs were assessed using two methods, One-Step Nucleic Acid Amplification (OSNA) and the conventional FFPE plus haematoxylin and eosin (H&E) staining. OSNA is an RT-PCR-based method for amplifying CK19 mRNA. Our aim was to assess the performance of OSNA and H&E in evaluating LNs to identify patients at risk of recurrence and to optimise their clinical management. We observed an 80.9% concordance in LN assessment using the two methods. In 9% of cases, LNs were found to be positive using H&E, and in 24.7% of cases, LNs were found to be positive using OSNA. The OSNA results are provided as the total tumour load (TTL), defined as the total tumour burden present in all the LNs of a surgical specimen. In CRC, a TTL ≥ 6000 CK19 m-RNA copies/µL is associated with poor prognosis. Three patients had TTL > 6000 copies/μL, which was associated with higher tumour budding. The discrepancies observed between the OSNA and H&E results were mostly attributed to tumour allocation bias. We concluded that LN assessment with OSNA enables the identification of pT1 CRC patients at some risk of recurrence and helps to optimise their clinical management.https://www.mdpi.com/2072-6694/15/22/5481pT1 colorectal cancerlymph nodestagingdiagnosisOSNA |
| spellingShingle | Karmele Saez de Gordoa Maria Teresa Rodrigo-Calvo Ivan Archilla Sandra Lopez-Prades Alba Diaz Jordi Tarragona Isidro Machado Juan Ruiz Martín Diana Zaffalon Maria Daca-Alvarez Maria Pellisé Jordi Camps Miriam Cuatrecasas Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre Study Cancers pT1 colorectal cancer lymph node staging diagnosis OSNA |
| title | Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre Study |
| title_full | Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre Study |
| title_fullStr | Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre Study |
| title_full_unstemmed | Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre Study |
| title_short | Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence: A Multicentre Study |
| title_sort | lymph node molecular analysis with osna enables the identification of pt1 crc patients at risk of recurrence a multicentre study |
| topic | pT1 colorectal cancer lymph node staging diagnosis OSNA |
| url | https://www.mdpi.com/2072-6694/15/22/5481 |
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