Cytology Smears: An enhanced alternative method for colorectal cancer pN Stage-A multicentre study

Stage II colorectal cancer (CRC) recurrence remains a clinical problem. Some of these patients are true stage III CRC with a pN0 pathology stage. This large prospective multicentre cohort study aimed at evaluating the diagnostic ability of lymph node (LN) cytology smears to perform the pN stage and...

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Detalles Bibliográficos
Autores: Diaz-Mercedes, Sherley, Archilla, Ivan, Lahoz, Sara, Rodrigo-Calvo, María Teresa, Lopez-Prades, Sandra, Tarragona Foradada, Jordi, Landolfi, Stefania, Concha, Ángel, Machado, Isidro, Maurel, Joan, Chic, Nuria, Castells, Antoni, Balaguer, Francesc, Camps, Jordi, Cuatrecasas, Miriam
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universitat de Lleida (UdL)
Repositorio:Repositori Obert UdL
OAI Identifier:oai:repositori.udl.cat:10459.1/85222
Acceso en línea:https://doi.org/10.3390/cancers14246072
http://hdl.handle.net/10459.1/85222
Access Level:acceso abierto
Palabra clave:càncer colorectal
lymph node
staging
OSNA
cytology
Colorectal cancer
Lymph node
Staging
Diagnosis
Cytology
Descripción
Sumario:Stage II colorectal cancer (CRC) recurrence remains a clinical problem. Some of these patients are true stage III CRC with a pN0 pathology stage. This large prospective multicentre cohort study aimed at evaluating the diagnostic ability of lymph node (LN) cytology smears to perform the pN stage and compare it with the conventional haematoxylin and eosin (H&E) pathology pN stage. Additionally, we used the One-Step Nucleic Acid Amplification (OSNA), a high-sensitive molecular method of LN staging. A total of 3936 fresh LNs from 217 CRC surgical specimens were examined by three methods, H&E, LN cytology smears, and OSNA. H&E detected 29% of patients with positive LNs, cytology smears 35%, and OSNA 33.2% (p < 0.0001). H&E and cytology concordantly classified 92.2% of tumours, and 88.5% between OSNA and HΕ Cytology had 96.8% sensitivity and 90.3% specificity to discriminate positive/negative patients compared to H&E (p = 0.004), and 87.3% sensitivity and 89% specificity when compared to OSNA (p = 0.56). Patients with positive LNs detected by any of the three methods had significantly worse disease-free and overall survival. We conclude that pN stage accuracy for detecting positive LNs is superior with LN cytological smears than with conventional H&E, which would enable a better pN stage and management of early-stage CRC patients.

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