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One-step nucleic acid amplification for detecting lymph node metastasis of head and neck squamous cell carcinoma

Lucie Peigne 1 Florence Godey 2 Mathieu Le Gallo 3 François Le Gall 1 Alain Fautrel 4 Jeff Morcet 5 Franck Jégoux 3, * 
* Corresponding author
4 H2P2 - H2P2 - Histo Pathologie Hight Precision
UR1 - Université de Rennes 1, Biosit : Biologie - Santé - Innovation Technologique - Structure Fédérative de Recherche en Biologie et Santé de Rennes
Abstract : Background - 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. Objective - To compare OSNA analysis to pathological analysis in cN0 HNSCC. Materials and methods - 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. Results - 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%. Conclusion - 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 database number NCT02852343.
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Submitted on : Thursday, July 21, 2022 - 11:01:28 AM
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Lucie Peigne, Florence Godey, Mathieu Le Gallo, François Le Gall, Alain Fautrel, et al.. One-step nucleic acid amplification for detecting lymph node metastasis of head and neck squamous cell carcinoma. Oral Oncology, Elsevier, 2020, 102, pp.104553. ⟨10.1016/j.oraloncology.2019.104553⟩. ⟨hal-02470971⟩



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