Pelvic lymph node dissection (PLND) is the most accurate procedure for lymph node (LN) staging in prostate cancer (PCa) patients. LN sectioning and hematoxylin and eosin (H&E) staining of at least one slice remains the gold standard for LN evaluation, potentially leading to misdetection of small metastatic focus. Entire LN analysis is possible with One-Step Nucleic Acid Amplification (OSNA) by detecting cytokeratin 19 (CK19) mRNA as a surrogate for LN invasion. This study aimed to compare postoperative performance of OSNA pooling with conventional H&E staining for pathological LN detection in PCa patients. POPCORN was an observational, prospective, and multicenter study of patients with PCa who underwent PLND. Dissected LNs were analyzed by both methods. This study included 2503 LNs from 131 patients, showing no statistically significant differences in pathological LN detection. Concordance between methods was high (93.9%), as were specificity (96.6%) and negative predictive value (96.6%) of OSNA pooling. The measure of agreement (Cohen's Kappa [κ]) was 0.70. Only eight (6.1%) discordances were observed, including four misdetections from each method. Results showed a high concordance between OSNA pooling and H&E staining, suggesting that OSNA pooling may be a good alternative to H&E staining to detect LN metastases in PCa patients.
International journal of molecular sciences. 2024 Dec 17*** epublish ***
Mercè Cuadras, Maria E Semidey, Jacques Planas, Inés M de Torres, Lucas Regis, Ana Celma, Enrique Trilla, Santiago Ramón Y Cajal, Rafael A Medina, Belén Congregado, David Marcilla, Miguel A Japón, Miguel Ramirez, Ana Calatrava-Fons, Asier Leivar, María B Alonso, Eugenia García, Pilar González-Peramato, Dario Vazquez-Martul, Ángel Concha-López, Venancio Chantada, Francisco J Queipo, José L Gago, Cristina Carrato, Rafael J Luque, Juan Moreno-Jimenez, Inmaculada Catalina-Fernández, Cristina León, Juan Morote
Urology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain., Pathology Department, Vall d'Hebron University Hospital, 08035 Barcelona, Spain., Urology Department, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain., Pathology Department, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain., Clínica Urosalud, 46021 Valencia, Spain., Pathology Department, Institut Valencià d'Oncologia, 46009 Valencia, Spain., Urology Department, Hospital Universitario La Paz, 28046 Madrid, Spain., Pathology Department, Hospital Universitario La Paz, 28046 Madrid, Spain., Urology Department, Hospital Universitario A Coruña, 15006 A Coruña, Spain., Pathology Department, Hospital Universitario A Coruña, 15006 A Coruña, Spain., Urology Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain., Pathology Department, Hospital Universitari Germans Trias i Pujol, 08916 Badalona, Spain., Pathology Department, Hospital Universitario de Jaén, 23007 Jaén, Spain., Urology Department, Hospital Universitario de Jaén, 23007 Jaén, Spain., Pathology Department, Hospital Universitario de Puerto Real, 11510 Cádiz, Spain., Urology Department, Hospital Universitario Puerta del Mar, 11510 Cádiz, Spain.