ワンステップ核酸増幅法（OSNA）を用いたリンパ節におけるNSCLCのマイクロメタスターゼのより高感度な検出

A more sensitive detection of micrometastases of NSCLC in lymph nodes using the one-step nucleic acid amplification (OSNA) method.

• Josef Vodicka
• Petr Mukensnabl
• Sarka Vejvodova
• Vladimir Spidlen
• Vlastimil Kulda
• Ondrej Topolcan
• Martin Pesta

抄録

背景:

根治的手術による肺腫瘍の治療中に摘出されたリンパ節（LN）からの腫瘍細胞の検出は、標準的な病理組織学的方法では限界がある。本研究の目的は、リンパ節内の微小転移をより高感度に検出することで、より正確なpTNMの状態を得ることである。

BACKGROUND: Detection of tumor cells in lymph nodes (LNs) removed during the treatment of pulmonary tumor by radical surgery is limited by the possibilities of standard histopathological methods. The goal of this study was to obtain more accurate pTNM status by a more sensitive detection of micrometastases in LNs.

方法:

METHODS: A total of 885 LNs, an average of 13.8 LNs per patient, were removed during 64 surgeries. LNs from the same zone were pooled together as a group, five groups of LNs were examined in each patient. A total of 320 groups of LNs were examined. One-step nucleic acid amplification (OSNA) method was compared to standard histopathological examination with haematoxylin-eosin (H&E) staining and CK19 immunohistochemistry, specifically by an ultimate analysis of all intraoperatively removed LNs.

結果:

RESULTS: Identical results for H&E and OSNA examinations were recorded in 286 groups of LNs (89.4%). In total, positive examinations were recorded in 27 groups of LNs (8.4%) using the OSNA method, which were H&E negative. In seven groups of LNs (2.2%), the H&E examination was positive, while OSNA method produced negative results.

結論:

OSNA検査の結果、14例（21.9％）でpTNMの病期分類が高くなった。臨床的意義については、引き続き追跡調査の対象となっている。

CONCLUSIONS: The OSNA examination led to a higher pTNM stage classification in 14 (21.9%) patients. The clinical significance remains the subject of follow-up research.

© 2017 Wiley Periodicals, Inc.