Performance and Prognostic Relevance of Lymph Node Assessment by One-Step Nucleic Acid Amplification Assay in Rectal Cancer

Background/Objectives: Lymph node metastases (LNM) undetected by standard hematoxylin and eosin (H&E) have been associated with unfavorable prognosis in colorectal cancer. The One-Step Nucleic Acid Amplification (OSNA) assay has demonstrated superior sensitivity in detecting LNM compared to H&am...

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Detalles Bibliográficos
Autores: Liu, Qing|||0000-0003-1784-6400, López-Prades, Sandra|||0000-0001-8208-2959, Saez de Gordoa, Karmele|||0000-0001-8106-6121, Rodrigo Calvo, María Teresa|||0000-0001-6675-3425, Garcia Gerona, Mireia|||0000-0003-3445-9744, Ruiz Martin, Juan, Romo-Navarro, Ángel|||0000-0002-7094-8484, Pinilla Pagnon, Ignacio|||0000-0002-6120-8302, Tarragona, Jordi|||0000-0002-1459-4087, Otero Alén, Begoña|||0000-0002-2876-6732, Camps Polo, Jordi|||0000-0003-2929-4228, Archilla, Ivan|||0000-0002-2142-0608, Cuatrecasas, Miriam|||0000-0003-3063-0110
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:318774
Acceso en línea:https://ddd.uab.cat/record/318774
https://dx.doi.org/urn:doi:10.3390/cancers17132141
Access Level:acceso abierto
Palabra clave:Rectal carcinoma
Lymph node metastases
Staging
Diagnosis
Prognosis
OSNA
Descripción
Sumario:Background/Objectives: Lymph node metastases (LNM) undetected by standard hematoxylin and eosin (H&E) have been associated with unfavorable prognosis in colorectal cancer. The One-Step Nucleic Acid Amplification (OSNA) assay has demonstrated superior sensitivity in detecting LNM compared to H&E. We aimed to assess the performance of OSNA in detecting LNM, as well as its prognostic value in rectal cancer (RC) patients. Methods: Lymph nodes (LNs) of patients from 15 centers were analyzed by both H&E and OSNA. The total tumor load (TTL) was defined as the sum of cytokeratin 19 mRNA copies/µL in all LNs from a surgical specimen, using a threshold of 250 copies/μL for OSNA positivity. Cox proportional hazard regression was used to assess the effect of TTL ≥ 250 or 6000 copies/μL on cancer-specific survival (CSS) and recurrence-free survival (RFS), with Firth's method applied to account for low event rate. Results: A total of 97 RC patients were included. Of these, 84 patients were eligible for survival analysis. The sensitivity and specificity of OSNA, compared to H&E, were 91.7% and 84.7%, respectively. TTL ≥ 6000 versus <6000 copies/μL was related to worse CSS and RFS. When dividing TTL into three groups: ≤250, 250-6000, and.

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