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Intraoperative Sentinel Lymph Node Evaluation: Implications of Cytokeratin 19 Expression for the Adoption of OSNA in Oral Squamous Cell Carcinoma

BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a “clinic-re...

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Autores principales: Shaw, Richard, Christensen, Anders, Java, Kapil, Maddani, Rehab El, Liloglou, Triantafillos, Asterios, Triantafyllou, von Buchwald, Christian, Wessel, Irene, Kiss, Katalin, Kjaer, Andreas, Lelkaitis, Giedrius, Long, Anna, Risk, Janet, Robinson, Max
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047925/
https://www.ncbi.nlm.nih.gov/pubmed/27393570
http://dx.doi.org/10.1245/s10434-016-5337-6
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author Shaw, Richard
Christensen, Anders
Java, Kapil
Maddani, Rehab El
Liloglou, Triantafillos
Asterios, Triantafyllou
von Buchwald, Christian
Wessel, Irene
Kiss, Katalin
Kjaer, Andreas
Lelkaitis, Giedrius
Long, Anna
Risk, Janet
Robinson, Max
author_facet Shaw, Richard
Christensen, Anders
Java, Kapil
Maddani, Rehab El
Liloglou, Triantafillos
Asterios, Triantafyllou
von Buchwald, Christian
Wessel, Irene
Kiss, Katalin
Kjaer, Andreas
Lelkaitis, Giedrius
Long, Anna
Risk, Janet
Robinson, Max
author_sort Shaw, Richard
collection PubMed
description BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a “clinic-ready” intraoperative diagnostic test (one step nucleic acid amplification—OSNA, sysmex). METHODS: Two cohorts were assembled: cohort 1, OSCC with stage and site that closely match cases suitable for sentinel lymph node biopsy (SLNB); cohort 2, HNSCC with sufficient fresh tumour tissue available for the OSNA assay (>50 mg). CK19 assays included qRT-PCR, RNA in situ hybridisation (ISH), and immunohistochemistry (IHC), as well as OSNA. RESULTS: CK19 mRNA expression was detected with variable sensitivity, depending on method, in 60–80% of primary OSCC tumours, while protein expression was observed in only 50% of tumours. Discordance between different techniques indicated that OSNA was more sensitive than qRT-PCR or RNA-ISH, which in turn were more sensitive than IHC. OSNA results showed CK19 expression in 80% of primary cases, so if used for diagnosis of lymph node metastasis would lead to a false-negative result in 20% of patients with cervical lymph node metastases. CONCLUSIONS: OSNA in its current form is not suitable for use in OSCC SLNB due to inadequate expression of the CK19 target in all case. However, the same assay technology would likely be very promising if applied using a more ubiquitous squamous epithelial target. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1245/s10434-016-5337-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-50479252016-10-18 Intraoperative Sentinel Lymph Node Evaluation: Implications of Cytokeratin 19 Expression for the Adoption of OSNA in Oral Squamous Cell Carcinoma Shaw, Richard Christensen, Anders Java, Kapil Maddani, Rehab El Liloglou, Triantafillos Asterios, Triantafyllou von Buchwald, Christian Wessel, Irene Kiss, Katalin Kjaer, Andreas Lelkaitis, Giedrius Long, Anna Risk, Janet Robinson, Max Ann Surg Oncol Head and Neck Oncology BACKGROUND: Intraoperative analysis of sentinel lymph nodes would enhance the care of early-stage oral squamous cell carcinoma (OSCC). We determined the frequency and extent of cytokeratin 19 (CK19) expression in OSCC primary tumours and surrounding tissues to explore the feasibility of a “clinic-ready” intraoperative diagnostic test (one step nucleic acid amplification—OSNA, sysmex). METHODS: Two cohorts were assembled: cohort 1, OSCC with stage and site that closely match cases suitable for sentinel lymph node biopsy (SLNB); cohort 2, HNSCC with sufficient fresh tumour tissue available for the OSNA assay (>50 mg). CK19 assays included qRT-PCR, RNA in situ hybridisation (ISH), and immunohistochemistry (IHC), as well as OSNA. RESULTS: CK19 mRNA expression was detected with variable sensitivity, depending on method, in 60–80% of primary OSCC tumours, while protein expression was observed in only 50% of tumours. Discordance between different techniques indicated that OSNA was more sensitive than qRT-PCR or RNA-ISH, which in turn were more sensitive than IHC. OSNA results showed CK19 expression in 80% of primary cases, so if used for diagnosis of lymph node metastasis would lead to a false-negative result in 20% of patients with cervical lymph node metastases. CONCLUSIONS: OSNA in its current form is not suitable for use in OSCC SLNB due to inadequate expression of the CK19 target in all case. However, the same assay technology would likely be very promising if applied using a more ubiquitous squamous epithelial target. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1245/s10434-016-5337-6) contains supplementary material, which is available to authorized users. Springer International Publishing 2016-07-08 2016 /pmc/articles/PMC5047925/ /pubmed/27393570 http://dx.doi.org/10.1245/s10434-016-5337-6 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Head and Neck Oncology
Shaw, Richard
Christensen, Anders
Java, Kapil
Maddani, Rehab El
Liloglou, Triantafillos
Asterios, Triantafyllou
von Buchwald, Christian
Wessel, Irene
Kiss, Katalin
Kjaer, Andreas
Lelkaitis, Giedrius
Long, Anna
Risk, Janet
Robinson, Max
Intraoperative Sentinel Lymph Node Evaluation: Implications of Cytokeratin 19 Expression for the Adoption of OSNA in Oral Squamous Cell Carcinoma
title Intraoperative Sentinel Lymph Node Evaluation: Implications of Cytokeratin 19 Expression for the Adoption of OSNA in Oral Squamous Cell Carcinoma
title_full Intraoperative Sentinel Lymph Node Evaluation: Implications of Cytokeratin 19 Expression for the Adoption of OSNA in Oral Squamous Cell Carcinoma
title_fullStr Intraoperative Sentinel Lymph Node Evaluation: Implications of Cytokeratin 19 Expression for the Adoption of OSNA in Oral Squamous Cell Carcinoma
title_full_unstemmed Intraoperative Sentinel Lymph Node Evaluation: Implications of Cytokeratin 19 Expression for the Adoption of OSNA in Oral Squamous Cell Carcinoma
title_short Intraoperative Sentinel Lymph Node Evaluation: Implications of Cytokeratin 19 Expression for the Adoption of OSNA in Oral Squamous Cell Carcinoma
title_sort intraoperative sentinel lymph node evaluation: implications of cytokeratin 19 expression for the adoption of osna in oral squamous cell carcinoma
topic Head and Neck Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047925/
https://www.ncbi.nlm.nih.gov/pubmed/27393570
http://dx.doi.org/10.1245/s10434-016-5337-6
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