Abstract | BACKGROUND: METHODS: For this study, 300 LNs, 115 sentinel lymph nodes (SLNs), and 185 non-SLNs from 88 breast cancer patients treated with NAC were examined by means of histology ( hematoxylin and eosin staining and pancytokeratin immunostaining) and OSNA. RESULTS: The diagnostic accuracy, sensitivity, and specificity of OSNA were respectively 92.3, 88.5, and 93.3 % for all LNs, and the corresponding values were 87.8, 75.0, and 91.2 % for SLNs and 95.1, 97.3, and 94.6 % for non-SLNs. The diagnostic accuracy of OSNA was significantly lower for SLNs than for non-SLNs (P = 0.021), which was attributable to the low sensitivity for detection of micrometastases (micromets) due to lower CK19 mRNA expression detected by in situ hybridization (ISH) in SLN micromets than in non-SLN micromets. For primary breast tumors, CK19 mRNA expression showed a significant reduction after NAC (P = 0.040). CONCLUSIONS: The diagnostic accuracy of OSNA for NAC-treated patients is similar to that for NAC-nontreated patients, but its accuracy is significantly lower for SLNs than for non-SLNs. The findings obtained with CK19 mRNA ISH suggest that most SLN micromets cannot be detected by OSNA due to the reduced expression of CK19 mRNA induced by NAC.
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Authors | Kaori Takamoto, Kenzo Shimazu, Yasuto Naoi, Atsushi Shimomura, Masafumi Shimoda, Naofumi Kagara, Seung Jin Kim, Yasuhiro Tamaki, Shinzaburo Noguchi |
Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 23
Issue 1
Pg. 78-86
(Jan 2016)
ISSN: 1534-4681 [Electronic] United States |
PMID | 26152274
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers, Tumor
- Keratin-19
- RNA, Messenger
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Topics |
- Adolescent
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Axilla
- Biomarkers, Tumor
(genetics, metabolism)
- Breast Neoplasms
(drug therapy, genetics, pathology)
- Carcinoma, Ductal, Breast
(drug therapy, genetics, secondary)
- Carcinoma, Lobular
(drug therapy, genetics, secondary)
- Female
- Follow-Up Studies
- Humans
- Immunoenzyme Techniques
- Keratin-19
(genetics, metabolism)
- Lymph Nodes
(drug effects, pathology)
- Lymphatic Metastasis
- Middle Aged
- Neoadjuvant Therapy
- Neoplasm Invasiveness
- Neoplasm Staging
- Nucleic Acid Amplification Techniques
(methods)
- Prognosis
- RNA, Messenger
(genetics)
- Real-Time Polymerase Chain Reaction
- Reverse Transcriptase Polymerase Chain Reaction
- Survival Rate
- Young Adult
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