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Multicentre evaluation of intraoperative molecular analysis of sentinel lymph nodes in breast carcinoma
British journal of surgery, 2011-04, Vol.98 (4), p.527-535
Snook, K. L.
Layer, G. T.
Jackson, P. A.
de Vries, C. S.
Shousha, S.
Sinnett, H. D.
Nigar, E.
Singhal, H.
Chia, Y.
Cunnick, G.
Kissin, M. W.
2011
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Snook, K. L.
Layer, G. T.
Jackson, P. A.
de Vries, C. S.
Shousha, S.
Sinnett, H. D.
Nigar, E.
Singhal, H.
Chia, Y.
Cunnick, G.
Kissin, M. W.
Titel
Multicentre evaluation of intraoperative molecular analysis of sentinel lymph nodes in breast carcinoma
Ist Teil von
British journal of surgery, 2011-04, Vol.98 (4), p.527-535
Ort / Verlag
Chichester, UK: John Wiley & Sons, Ltd
Erscheinungsjahr
2011
Quelle
MEDLINE
Beschreibungen/Notizen
Background: Ideally, intraoperative sentinel lymph node (SLN) analysis in breast cancer should be automated, have high concordance with extensive histopathology, and be applicable in any hospital setting. A prospective multicentre evaluation of the one‐step nucleic acid amplification (OSNA) automated molecular diagnostic system of SLN analysis was undertaken. Methods: Intraoperative examination of SLNs from 204 patients with breast cancer was performed by OSNA at four sites in the UK. Half of each SLN was assessed by OSNA (for cytokeratin 19 mRNA) and the remaining half was paraffin embedded for intensive histological examination at ten levels. Discordant cases were reanalysed by further molecular biological techniques and by additional histological examination of all remaining nodal material to ascertain whether the discordance was due to an uneven distribution of metastases, known as tissue allocation bias (TAB). Results: After exclusion of samples affected by TAB, the overall concordance rate for OSNA versus histopathology was 96·0 per cent, with a sensitivity of 91·7 per cent and a specificity of 96·9 per cent. The median time to process a single SLN was 32 (range 22–97) min, and that for two nodes 42 (30–73) min. Conclusion: OSNA enables accurate automated intraoperative diagnosis and can be used successfully in different UK hospitals. When the SLN is shown to be positive, the patient can undergo immediate axillary clearance under the same anaesthetic rather than having a delayed second procedure. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Do we need pathology?
Sprache
Englisch
Identifikatoren
ISSN: 0007-1323
eISSN: 1365-2168
DOI: 10.1002/bjs.7347
Titel-ID: cdi_proquest_miscellaneous_871382628
Format
–
Schlagworte
Biological and medical sciences
,
Breast - pathology
,
Breast Neoplasms - chemistry
,
Breast Neoplasms - pathology
,
Breast Neoplasms - surgery
,
Feasibility Studies
,
Female
,
General aspects
,
Gynecology. Andrology. Obstetrics
,
Humans
,
Intraoperative Care - methods
,
Keratin-19 - analysis
,
Mammary gland diseases
,
Medical sciences
,
Nucleic Acid Amplification Techniques - methods
,
Prospective Studies
,
RNA, Messenger - analysis
,
Sensitivity and Specificity
,
Sentinel Lymph Node Biopsy - methods
,
Tumors
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