The Diagnostic Accuracy of One-Step Nucleic Acid Amplification for Lymph Node Metastases of Papillary Thyroid Carcinoma： A Systematic Review and Meta-Analysis.
Ontology highlight
ABSTRACT: Background
One-step nucleic acid amplification (OSNA) analysis is a molecular diagnostic technique for lymph node metastases (LNMs) by quantifying cytokeratin 19(CK 19) mRNA. We aim to evaluate the intraoperative diagnostic accuracy of OSNA assay for LNMs of papillary thyroid carcinoma (PTC).Methods
PubMed, Embase, Cochrane Library, and Web of Science databases were searched to retrieve related literature. A meta-analysis was performed using STATA11.0, Meta-Disc 1.4 and RevMan 5.3.Results
This meta-analysis included six studies involving 987 lymph nodes from 194 patients. The pooled sensitivity, specificity, and area under the summary receiver-operating characteristic curve (AUC) of OSNA for detecting LNM were 0.88, 0.90, and 0.95, respectively.Conclusion
OSNA assay is an accurate molecular diagnosis for intraoperative detection of lymph node metastasis in PTC.
SUBMITTER: Wang X
PROVIDER: S-EPMC8764176 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BackgroundThe incidence of node metastases in papillary thyroid carcinoma (PTC) is high, ranging from 20% to 90%. Prophylactic central lymph node compartment dissection (CLND), suggested from the latest guidelines for high-risk tumors, meets resistance due to the high incidence of postoperative complications. Recently, new molecular biologic techniques, such as One Step Nucleic Acid Amplification (OSNA), have spread widely, allowing to quickly isolate, amplify and quantify mRNA encoding for proteins selectively present in neoplastic cells, as Cytokeratine-19. The aim of this study is to evaluate the application of OSNA to intraoperative diagnosis of node metastases of PTC.MethodsWe included in the study patients with preoperative diagnosis of PTC; from each patient one or more lymph nodes were collected. To assess OSNA accuracy, each lymph node was divided into two halves: the first one was analysed with histopathological and immunohistochemical examination, whereas the second was studied with OSNA.ResultsTwenty-six lymph nodes from 13 patients were included in the study. Overall, OSNA sensitivity was 87.5%, specificity 94.4%, positive predictive value 87.5%, negative predictive value 94.4% and accuracy 92.8%.Discussion and conclusionOSNA is effective in detecting lymph node metastases of PTC. Considering the high risk of complications in CLND, and the uncertain prognostic value of lymph node metastases of PTC, OSNA seems to be a promising tool to identify intraoperatively patients who may benefit from CLND.
| S-EPMC6717061 | biostudies-literature
Project description:BackgroundSub-centrimetric papillary thyroid carcinomas usually have a good prognosis with a cancer specific survival of > 99%, however in up to 65% of patients, lymph node metastases can be observed. Molecular alterations in BRAF, TERT and TP53 are associated with worse clinicopathological outcome in patients with papillary thyroid carcinoma.Material and methodsTwenty-two cases of papillary thyroid carcinomas measuring ≤ 1 cm with synchronous lymph node metastases were examined regarding morphological patterns and immunohistochemical status of p53, Ki-67, and BRAF V600E status. TERT RNA expression in lymph node metastases were evaluated by RNAScope®.ResultsMorphological patterns were heterogeneous in both primary tumors and lymph node metastases. Proliferation indices measured by Ki-67 were low. Both primary and lymph node metastases were wild type for p53 by immunohistochemical analysis. No lymph node metastasis showed TERT expression by RNAScope®.ConclusionsOur data indicate that TERT expression is not involved in the development early lymph node metastasis in patients with sub-centimetric PTC.
| S-EPMC11017548 | biostudies-literature
Project description:Background:Unilateral multifocal papillary thyroid microcarcinoma (UM-PTMC) is not rare, and the suitable extent of operation is controversial. Total thyroidectomy is associated with a high risk of hypoparathyroidism and recurrent laryngeal nerve injury. Hemithyroidectomy should be considered in patients without lymph node metastases. This study aimed to identify factors predicting central lymph node metastases (CLNM) in patients with UM-PTMC. Methods:A total of 1,453 patients with thyroid cancer underwent surgery at our hospital from January 2018 to June 2018, and 115 patients with UM-PTMC were selected and assessed retrospectively. The relationship between CLNM and clinicopathologic features of UM-PTMC were analyzed by both univariate and multivariate analyses. Results:Of the 115 patients with UM-PTMC, CLNM were confirmed by pathology in 57 patients. Univariate and multivariate analyses identified the sum diameter of all tumors (?1.0 cm) [odds ratio (OR) =2.295; 95% confidence interval (CI): 1.036-5.086; P=0.041] and positive CLNM via ultrasonography (OR =5.882; 95% CI: 1.562-22.153; P=0.009) as independent predictors of CLNM. Conclusions:CLNM are common in patients with UM-PTMC. The sum diameter of all tumors (?1.0 cm) and positive CLNM via ultrasonography are independent risk factors for CLNM. Our data should be considered in the decision process relating to performing total thyroidectomy or hemithyroidectomy in patients with UM-PTMC.
| S-EPMC7347816 | biostudies-literature
Project description:The health problems caused by the frequent relapse of papillary thyroid carcinoma (PTC) remain a worldwide concern since the morbidity rate of PTC ranks the highest among thyroid cancers. Residues from contralateral central lymph node metastases (con-CLNM) are the key reason for persistence or recurrence of unilateral papillary thyroid carcinoma (uni-PTC); however, the ability to assess the status of con-CLNM in uni-PTC patients is limited. To clarify the risk factors of con-CLNM, a total of 250 patients with uni-PTC who underwent total thyroidectomy and bilateral central lymph node dissection were recruited in this study. We compared the clinical, sonographic, and pathological characteristics of patients with con-CLNM to those without con-CLNM and established a nomogram for con-CLNM in uni-PTC. We found that male sex, without Hashimoto's thyroiditis, present capsular invasion, with ipsilateral lateral lymph node metastases, and the ratio of ipsilateral central lymph node metastases ≥0.16 were independent con-CLNM predictors of uni-PTC (ORs: 2.797, 0.430, 2.538, 2.202, and 26.588; 95% CIs: 1.182-6.617, 0.211-0.876, 1.223-5.267, 1.064-4.557, and 7.596-93.069, respectively). Additionally, a preoperative nomogram for the prediction of con-CLNM based on these risk factors showed good discrimination (C-index 0.881; 95% CI: 0.840-0.923; sensitivity 85.3%; specificity 76.0%) and good agreement via the calibration plot. Our study provided a way to quantitatively and accurately predict whether con-CLNM occurred in patients with uni-PTC, which may guide surgeons to evaluate the nodal status and perform tailored therapeutic central lymph node dissection.
| S-EPMC8263281 | biostudies-literature
Project description:The one-step nucleic acid amplification (OSNA) method allows for the quantitative evaluation of the tumor burden in resected lymph nodes (LNs) in patients with lung cancer. This technique enables to detect macro and micrometastases, facilitating the correct classification of patients for appropriate follow-up of the disease after surgery. Of 160 patients with resectable lung cancer whose LNs were examined by OSNA, H&E and CK19 IHC between July 2015 and December 2018, 110 patients with clinical stages from IA1 to IIIB were selected for follow-up. LN staging in lung cancer by pathological study led to understaging in 13.64% of the cases studied. OSNA allowed to quantify the tumor burden and establish a prognostic value. Patients with a total tumor load of ≥1650 cCP/uL were associated with a significantly increased likelihood of recurrence. Moreover, the survival of patients with <4405 cCP/uL was significantly higher than patients with ≥4405 cCP/uL. The OSNA assay is a rapid and accurate technique for quantifying the tumor burden in the LNs of lung cancer patients and OSNA quantitative data could allow to establish prognostic values for recurrence-free survival and overall survival in this type of malignancy.
| S-EPMC9776771 | biostudies-literature
Project description:BackgroundBlood and lymph vessel invasion are well-recognized markers of tumor aggressiveness, as these are the routes that lead to metastases. Thyroid tumors, depending on the histological variant, tend to have distinctive biological behaviors and use different vascular routes to metastasize, yet the mechanisms underlying the metastatic process are still poorly understood.ObjectivesThe aim of this study was to assess how the lymph vessel density (LVD) in different histological types of thyroid tumors, and in their surrounding tissue, correlate with the presence of lymph node metastases (LNM) and tumor pathological features.MethodsLymph vessels of papillary thyroid carcinomas (PTC), of the classical (CVPTC, n = 50) and follicular variants (FVPTC, n = 18), and medullary thyroid carcinomas (MTC, n = 34) were immunohistochemically stained against antigen D2-40. The stained area was quantified using a computerized morphometric analysis tool and correlated with the tumor pathological characteristics.ResultsLVD within all analyzed thyroid tumor subtypes was significantly lower than in the surrounding thyroid tissues (p < 0.001). Despite intratumoral LVD being significantly higher in CVPTC than in FVPTC, and peritumoral LVD being significantly higher in MTC than in PTC (p < 0.05), no correlations were found between LVD (either intratumoral or peritumoral) and the presence of lymph node metastasis.ConclusionsAs no LVD differences were found amongst thyroid tumors with or without LNM, dissemination is more likely to depend on the tumor ability to invade the abundant lymph vessel network of the surrounding thyroid tissue than on the ability of the tumor to promote de novo lymphangiogenesis.
| S-EPMC5422756 | biostudies-literature
Project description:Adolescents and young adults (AYA) describe the demographic aged between 15-39 years diagnosed with cancer. This group is particularly at risk of papillary thyroid carcinoma (PTC) with a greater severity compared with other ages. Through comparative design, the present study aimed to quantify central lymph node metastasis (CLNM) risk in AYAs. A total of 463 AYA patients with PTC and 489 patients >39 years old with PTC from Ningbo Medical Center Lihuili Hospital (Ningbo, China) were enrolled. Details such as demographic data, serum indices and fine-needle aspiration from the Electronic Medical Records System were extracted and analyzed. AYA patients had significantly higher rates of ipsilateral Hashimoto thyroiditis, thyroid capsular invasion (TCI), CLNM, larger tumors and more positive central lymph nodes (CLN). Independent risk factors of CLNM in AYA patients were as follows: Male sex, presence of TCI, multifocality, bilateral disease and maximum tumor diameter (MTD) ≥1.0 cm. Independent risk factors of lateral lymph node metastasis in AYAs with CLNM were as follows: MTD ≥1.0 cm, maximum diameter of positive CLN ≥1.0 cm, and presence of ipsilateral nodular goiter. Furthermore, AYA patients with PTC displayed significantly greater aggression in primary tumor invasion and neck lymph node metastasis. Based on these findings, a treatment stratification chart was created to guide the PTC treatment approach for AYAs. The present study is registered at the Chinese Clinical Trials Registry (trial registration no. ChiCTR2200064921) in November 2022.
| S-EPMC10955680 | biostudies-literature
Project description:This data was gathered from three patients who had papillary thyroid carcinoma with paired lymph node metastases. The goal of this study was to determine critical genes and pathway that influence the occurrence of lymph node metastasis in PTC patients. A total of 6 samples were analyzed, resulting in an average of 10.16 GB of data per sample. 1,967 new genes were predicted; 19,430 genes were detected as expressed, of which 17,890 were known genes and 1,540 were predicted new genes; 27,495 new transcripts were found, of which 15,846 belonged to known genes. There were a total of 27,495 novel transcripts discovered, with 15,846 belonging to new variable splice isoforms of known protein-coding genes, 1,967 to transcripts of new protein-coding genes, and 9,682 to long-stranded non-coding RNAs.
2023-05-31 | GSE202413 | GEO
Project description:PurposeTo determine whether dual-energy CT (DECT) has incremental diagnostic value when combined with ultrasound (US) in the diagnosis of metastatic cervical lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC).MethodsThis was a single-center retrospective cohort study of patients diagnosed with PTC between October 2019 and August 2020. US features of LNs to include hyperechogenicity, round shape, microcalcification, cystic component, and homogeneous/peripheral vascularity were considered suggestive of metastasis. The HU of arterial phase (HUarterial) and DECT-derived CT images [contrast media (CM) and areas under the 100 keV monoenergetic curve (AUC100keV)] were measured. Effective atomic numbers (Zeff), iodine concentration (mg/mL), and slope of the HU curve (λHU) were also obtained. The values for metastatic and benign LNs were compared using Student's t-test with false-discovery correction. Logistic regression with areas under the receiver operating characteristic curves (AUCs) were performed for predicting metastatic LNs.ResultsA total of 102 patients were included (49 metastatic and 53 benign LNs; mean age, 46±15 years). Metastatic LNs showed significantly higher values for HUarterial, CM, Zeff, λHU, AUC100keV, and iodine concentration (all, P = 0.001). In logistic regression, the HUarterial demonstrated the highest AUC (0.824; 95% confidence interval [CI], 0.751-0.897), followed by CM HU (0.762; 95% CI, 0.679-0.846). Combination of DECT parameters with US features improved the AUC from 0.890 to 0.941.ConclusionCompared to US features alone, combination with DECT-derived quantitative parameters improved diagnostic performance in predicting metastatic cervical LNs in patients with PTC.
| S-EPMC8668122 | biostudies-literature
Project description:BackgroundUnlike medullary thyroid carcinoma in adults, the vast majority of pediatric medullary thyroid carcinoma is hereditary. Pediatric medullary thyroid carcinoma is known to have different genetic alterations driving tumorigenesis, but it is not known if pediatric medullary thyroid carcinoma has different clinicopathologic features. This study aims to identify which pediatric medullary thyroid carcinoma patients might warrant elective neck dissection.MethodsWe selected all patients ages 0 to 19 diagnosed with clinically evident medullary thyroid carcinoma in the National Cancer Database between 2004 to 2016. Clinicopathologic factors, treatments, and outcomes were analyzed and compared between this cohort and adults (ages ≥20) with medullary thyroid carcinoma.ResultsOne hundred twenty-five pediatric medullary thyroid carcinoma (median age: 13) and 5,086 adult medullary thyroid carcinoma (median age: 57) patients were identified. Pediatric patients had smaller tumors (median diameter: 1.2 cm vs 2.0 cm; P < .001), lower rates of nodal metastases (n = 31, 36.9% vs 1,689, 50.4%; P = .02) but double the incidence of multifocal tumors (n = 70, 59.3%, vs 1,412, 29.9%; P < .001) compared with adults. Multifocal tumors conferred a significantly increased risk of nodal metastases in adult medullary thyroid carcinoma (64.4% vs 43.2%; P < .001) but not pediatric medullary thyroid carcinoma (37.7% vs 35.7%; P = .85). Nodal metastases were more frequent among older children (0-5 years: 0.0%, 6-12: 40.7%, 13-19: 41.7%; P = .04). However, rates of occult nodal metastases were similar between older children (6-19 years: n = 12, 21.4%) and adults (557, 25.8% P = .56).ConclusionPediatric medullary thyroid carcinoma has lower rates of lymph node metastases compared with adults. The risk of nodal disease was low among the youngest children, but older children ages 6 to 19 were at considerable risk for occult metastases. These findings could guide clinicians in selecting pediatric patients considered for elective lymph node dissection.
| S-EPMC9439710 | biostudies-literature