peptide-pva and Head-and-Neck-Neoplasms

In head and neck squamous cell carcinoma (HNSCC) 30% of cN0 patients have occult metastasis. LN invasion is a major prognostic factor. Sentinel lymph node (SLN) is an option for cN0 neck management. One-step nucleic acid amplification (OSNA) used to analyze SLN in breast cancer is also a candidate to get more reliable intraoperative HNSCC lymph node (LN) staging.. To compare OSNA analysis to pathological analysis in cN0 HNSCC.. 157 LN from 26 cN0 HNSCC patients were prospectively analyzed (6.3LN/patient). Exclusion criteria were previous surgery or radiotherapy. Each node was cut into 4 equal pieces alternatively sent to pathological analysis and OSNA technique. IHC CK19 was performed on the primary tumor biopsy and RT-qPCR of CK19, PVA and EPCAM on the LN lysate of discordant cases.. OSNA was able to provide intraoperative result in all patients. OSNA detected 21 metastases. There were 139 concordant LN (88.5%). There were 18 initial discordant LN (11.5%), 13 (8.3%) were OSNA positive/pathological analysis negative, 5 (3.2%) were OSNA negative/pathological analysis positive. After elimination of allocation bias, false negative rate was 1.3%, sensitivity and specificity were 90% and 95.6%, PPV and NPV were 75% and 98.5%.. Our results suggest that OSNA should be considered to improve SNB analysis both for increasing micro metastasis diagnosis and offer extemporaneous results. Study registered under clinicaltrials.gov database number NCT02852343.

Topics: Adult; Aged; Aged, 80 and over; Epithelial Cell Adhesion Molecule; Feasibility Studies; Female; Head and Neck Neoplasms; Humans; Keratin-19; Lymph Node Excision; Lymphatic Metastasis; Male; Middle Aged; Nucleic Acid Amplification Techniques; Oligopeptides; Prospective Studies; RNA, Messenger; Sensitivity and Specificity; Sentinel Lymph Node; Squamous Cell Carcinoma of Head and Neck