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Nodal metastatic load in papillary thyroid carcinoma. Morphological and molecular analysis with one-step nucleic acid amplification on more than 550 lymph nodes.

Authors
  • Iglesias, Carmela1
  • González, Oscar2
  • Temprana-Salvador, Jordi3
  • García-Burillo, Amparo4
  • Caubet, Enric2
  • Ramón Y Cajal, Santiago5
  • Zafon, Carles6
  • 1 Department of Pathology, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, 119-129 Passeig Vall d'Hebron, Barcelona, Spain; Translational Molecular Pathology Research Group (VHIR), Hospital Vall d'Hebron, 119-129 Passeig Vall d'Hebron, Barcelona, Spain. Electronic address: [email protected] , (Spain)
  • 2 Department of General Surgery, Endocrine Surgery Division, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, 119-129 Passeig Vall d'Hebron, Barcelona, Spain. , (Spain)
  • 3 Department of Pathology, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, 119-129 Passeig Vall d'Hebron, Barcelona, Spain. , (Spain)
  • 4 Department of Nuclear Medicine, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, 119-129 Passeig Vall d'Hebron, Barcelona, Spain. , (Spain)
  • 5 Department of Pathology, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, 119-129 Passeig Vall d'Hebron, Barcelona, Spain; Translational Molecular Pathology Research Group (VHIR), Hospital Vall d'Hebron, 119-129 Passeig Vall d'Hebron, Barcelona, Spain. , (Spain)
  • 6 Department of Endocrinology, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, 119-129 Passeig Vall d'Hebron, Barcelona, Spain. , (Spain)
Type
Published Article
Journal
Endocrinologia, diabetes y nutricion
Publication Date
May 01, 2021
Volume
68
Issue
5
Pages
346–353
Identifiers
DOI: 10.1016/j.endinu.2020.04.004
PMID: 32800751
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

The risk of recurrence in papillary thyroid carcinoma (PTC) is likely related to the amount of tumour in the metastatic lymph node (LN). Therefore, the current TNM classification (N0/N1) make it necessary to find a method to quantify the LN metastasis (LNM). We propose that the quantitative molecular assay One-Step Nucleic-Acid Amplification (OSNA), which measures the number of cytokeratin-19 (CK-19) mRNA copies as a marker of LNM, could play this role. Our objective was to describe the characteristics of the LNs from PTC, and to compare the morphological characteristics that have been claimed as criteria for metastatic burden with OSNA. Prospective study of LNs from 42 patients. All of the LNs were measured, weighed and analysed by OSNA and also by imprint cytology. A total of 573 LNs were included, 187 (32.6%) of them were OSNA-positives. The global consistency between cytology and OSNA was 87.4%. Significant differences were observed in the CK-19 copy number between the LNMs<0.2cm and those >3cm, as well as between those from 0.2 to 3cm with respect to those >3cm, but not between those <0.2cm and those between 0.2 and 3cm. The total tumour load per neck dissection showed no differences based on whether there were ≤5 or >5 LNMs. In our series the LNMs >3cm show an increased tumour load, but it is unclear if it is necessary to sub-classify the smaller ones as well as the relevance of the number of metastatic nodes according to the cut-off of 5 nodes. We consider that the OSNA analysis avoids the bias of nodal histology and allows for a greater understanding of its real oncological potential. Copyright © 2020. Publicado por Elsevier España, S.L.U.

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