Intraoperative prediction of non-sentinel lymph node metastases in breast cancer using cytokeratin 19 mRNA copy number: A retrospective analysis.
Fiche publication
Date publication
mars 2022
Journal
Molecular and clinical oncology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr HARLE Alexandre, Dr LEROUX Agnès, Pr MARCHAL Frédéric, Pr MERLIN Jean-Louis, Dr GILSON Pauline
Tous les auteurs :
Pina H, Salleron J, Gilson P, Husson M, Rouyer M, Leroux A, Rauch P, Marchal F, Käppeli M, Merlin JL, Harlé A
Lien Pubmed
Résumé
One-step nucleic acid amplification (OSNA) is a molecular procedure used intraoperatively for the detection of sentinel lymph node (SLN) metastases. The aim of the present study was to define a cut-off of cytokeratin (CK)19 mRNA copy number predictive of positive completion axillary lymph node dissection (ALND). The OSNA procedure was employed for SLN analysis in 812 patients with T1-T2 N0 breast cancer. A total of 197 patients with SLN metastases were retrospectively analyzed. A total of 40 patients (20%) had non-SLN metastases. Receiver operating characteristics curve analysis established a cut-off of 5,000 CK19 mRNA copy number with 75% sensitivity and 72% specificity. The positive and negative predictive values were 40.5 and 92%, respectively. Multivariate analysis showed that this cut-off and tumor localization in the outer or lower-outer quadrant of the breast were significantly associated with non-SNL involvement (P<0.001 and P=0.025, respectively). The findings of the present study support the conventional cut-off of 5,000 copies for intraoperative decision to perform ALND, whereas ALND can safely be avoided in patients with tumor located outside the outer or lower-outer quadrant of the breast if the CK19 mRNA copy number is <5,000.
Mots clés
breast cancer, one-step nucleic acid amplification, sentinel lymph node
Référence
Mol Clin Oncol. 2022 Mar;16(3):58