Annals of Coloproctology

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Original Article

Sentinel Lymph Node Analysis in Colorectal Cancer Patients Using One-Step Nucleic Acid Amplification in Combination With Fluorescence and Indocyanine Green: Francesco Esposito, Adele Noviello, Nicola Moles, Enrico Coppola Bottazzi, Mario Baiamonte, Ina Macaione, Umberto Ferbo, Maria Lepore, Antonio Miro, Francesco Crafa; Ann Coloproctol. 2019;35(4):174-180. Published online August 31, 2019; DOI: https://doi.org/10.3393/ac.2018.07.21.1

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Purpose
Analysis of the sentinel lymph node (SLN) in colorectal cancer (CRC) patients was proposed for more accurate staging and tailored lymphadenectomy. The aim of this study was to assess the ability to predict lymph node (LN) involvement through analysis of the SLN with a one-step nucleic acid (OSNA) technique in combination with peritumoral injection of indocyanine green (ICG) and near-infrared (NIR) lymphangiography in CRC patients.
Methods
A total of 34 patients were enrolled. Overall, 51 LNs were analyzed with OSNA. LNs of 17 patients (50%) were examined simultaneously with hematoxylin and eosin (H&E) and OSNA.
Results
SLN analysis of 17 patients examined with H&E and OSNA revealed that OSNA had a higher sensitivity (1 vs. 0.55), higher negative predictive value (1 vs. 0.66) and higher accuracy (100% vs. 76.4%) in predicting LN involvement. Overall, OSNA showed a sensitivity of 0.69, specificity of 1, accuracy of 88.2%, and stage migration of 8.8%. Compared to those who were OSNA (−), OSNA (+) patients had a greater number of LN metastases (4.8 vs. 0.16, P = 0.04), higher G3 rate (44.4% vs. 4%, P = 0.01), more advanced stage of disease (stage III: 77.8% vs. 16%; P = 0.00) and were more rapidly subjected to adjuvant chemotherapy (39.1 days vs. 50.2 days, P = 0.01).
Conclusion
SLN analysis with OSNA in combination with ICG-NIR lymphangiography is feasible and can detect LN involvement in CRC patients. Furthermore, it allows for more accurate staging reducing the delay between surgery and adjuvant chemotherapy.

Citations

Citations to this article as recorded by

Diagnostic value of one-step nucleic acid amplification for sentinel lymph node metastasis in cytokeratin 19-positive tumors: evidence from bioinformatics and meta-analysis
Ke Li, Min Meng, Weiwei Zhang, Junyi Li, Yiting Wang, Changhui Zhou
Frontiers in Oncology.2024;[Epub] CrossRef
Non-exposed endoscopic wall-inversion surgery with one-step nucleic acid amplification for early gastrointestinal tumors: Personal experience and literature review
Francesco Crafa, Serafino Vanella, Aristide Morante, Onofrio A Catalano, Kelsey L Pomykala, Mario Baiamonte, Maria Godas, Alexandra Antunes, Joaquim Costa Pereira, Valentina Giaccaglia
World Journal of Gastroenterology.2023; 29(24): 3883. CrossRef
Role of one-step nucleic acid amplification in colorectal cancer lymph node metastases detection
Francesco Crafa, Serafino Vanella, Onofrio A Catalano, Kelsey L Pomykala, Mario Baiamonte
World Journal of Gastroenterology.2022; 28(30): 4019. CrossRef
Mapping Lymph Node during Indocyanine Green Fluorescence-Imaging Guided Gastric Oncologic Surgery: Current Applications and Future Directions
Yiqun Liao, Jiahao Zhao, Yuji Chen, Bin Zhao, Yongkun Fang, Fei Wang, Chen Wei, Yichao Ma, Hao Ji, Daorong Wang, Dong Tang
Cancers.2022; 14(20): 5143. CrossRef
The advantage of one‐step nucleic acid amplification for the diagnosis of lymph node metastasis in colorectal cancer patients
Yukiharu Hiyoshi, Takashi Akiyoshi, Yosuke Fukunaga
Annals of Gastroenterological Surgery.2021; 5(1): 60. CrossRef
The evolving role of one-step nucleic acid amplification (OSNA) for the intra-operative detection of lymph node metastases: A diagnostic accuracy meta-analysis
Anastasios Tranoulis, Dimitra Georgiou, Jason Yap, Stephen Attard-Montalto, Jeremy Twigg, Ahmed Elattar, Kavita Singh, Janos Balega, Sean Kehoe
European Journal of Surgical Oncology.2021; 47(6): 1233. CrossRef

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