Lymph Node Molecular Analysis with OSNA Enables the Identification of pT1 CRC Patients at Risk of Recurrence : A Multicentre Study
Saez de Gordoa, Karmele (Hospital Clínic i Provincial de Barcelona)
Rodrigo-Calvo, Maria Teresa (Hospital Clínic i Provincial de Barcelona)
Archilla, Ivan (Hospital Clínic i Provincial de Barcelona)
Lopez-Prades, Sandra (Hospital Clínic i Provincial de Barcelona)
Díaz, Alba (Hospital Clínic i Provincial de Barcelona)
Tarragona, Jordi (Hospital Arnau de Vilanova (Lleida, Catalunya))
Machado, Isidro (Centro de Investigación Biomédica en Red en Cancer (CIBERONC))
Ruiz Martín, Juan (Virgen de la Salud Hospital, Toledo)
Zaffalon, Diana (Consorci Sanitari de Terrassa)
Daca-Alvarez, Maria (Hospital Clínic i Provincial de Barcelona)
Pellisé, Maria (Hospital Clínic i Provincial de Barcelona)
Camps, Jordi (Universitat Autònoma de Barcelona. Departament de Biologia Cel·lular, de Fisiologia i d'Immunologia)
Cuatrecasas, Miriam (Hospital Clínic i Provincial de Barcelona)

Data:	2023
Resum:	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.
Ajuts:	Instituto de Salud Carlos III PI20/00863 Instituto de Salud Carlos III PI19/01050
Nota:	Altres ajuts: Beca de la Marató de TV3 2020 (Beca la Marato-201932-30)
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Pt1 colorectal cancer ; Lymph node ; Staging ; Diagnosis ; OSNA
Publicat a:	Cancers, Vol. 15 (november 2023) , ISSN 2072-6694

DOI: 10.3390/cancers15225481
PMID: 38001742

13 p, 1.8 MB

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