Molecular Staging of Patients with Colon Cancer. The C-Closer-II Study: A Multicentre Study in Portugal

Authors

  • María José Brito Serviço de Anatomia Patológica. Hospital Garcia de Orta. Almada.
  • Mrinalini Honavar Serviço de Anatomia Patológica. Hospital Pedro Hispano. Matosinhos.
  • Maria Augusta Cipriano Serviço de Anatomia Patológica. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Joanne Lopes Serviço de Anatomia Patológica. Centro Hospitalar de São João. Porto.
  • Helder Coelho Serviço de Anatomia Patológica. Hospital Garcia de Orta. Almada.
  • António Rodrigues da Silva Serviço de Cirurgia Geral. Hospital Pedro Hispano. Matosinhos.
  • Mário Silva Serviço de Anatomia Patológica. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Susana Guimarães Serviço de Anatomia Patológica. Centro Hospitalar de São João. Porto.
  • Amaro Frutuoso Serviço de Anatomia Patológica. Hospital Pedro Hispano. Matosinhos.
  • Ana Gomes Serviço de Anatomia Patológica. Centro Hospitalar e Universitário de Coimbra. Coimbra.
  • Elisabete Barbosa Serviço de Cirurgia Geral. Centro Hospitalar de São João. Porto.
  • Sandra Carlos Serviço de Cirurgia Geral. Hospital Garcia de Orta. Almada.

DOI:

https://doi.org/10.20344/amp.9696

Keywords:

Colorectal Neoplasms, Lymph Nodes, Lymphatic Metastasis, Neoplasm Staging, Nucleic Acid Amplification Techniques

Abstract

Introduction: Approximately 20% - 30% of histological lymph node-negative patients with colorectal cancer relapse at five years after surgical treatment. This recurrence is likely due to occult nodal disease undetected by standard histopathological practice which has implications in terms of the clinical management of patients.
Material and Methods: Lymph nodes were collected from colectomy specimens. A central section from each lymph node was histologically examined following haematoxylin-eosin staining and the remaining tissue was subjected to OSNA - one step nucleic acid amplification analysis.
Results: A total of 1046 lymph nodes from 59 pN0 patients were assessed. Of these, 753 lymph nodes were examined by both methods. The median number of lymph nodes assessed with OSNA - one step nucleic acid amplification was 12 (IQR: 7;16). Among pN0 patients, 17 had OSNA - one step nucleic acid amplification-positive lymph nodes, resulting in a positive molecular staging rate of 28.8% (95% CI: 17.8 - 42.1). Among these patients, 12 (70.59%) were molecular-staged as pN1 and 5 (29.41%) were molecular staged as pN2. The tumour burden of lymph nodes assessed with OSNA - one step nucleic acid amplification ranged from 270 to 17 000 cytokeratin 19 mRNA copies/μL. Most of these patients (88.2%) were found to have lymph nodes with micrometastases only (250 - 4999 copies/μL).
Discussion: We provide the results from the first study of the use of the OSNA - one step nucleic acid amplification assay in colorectal cancer patients in Portugal. Our results are in-line with other international studies, showing the improvement on patients’ staging by molecular examination of lymph nodes.
Conclusion: In our study, 28.8% of patients with histologically negative lymph nodes were found to have metastatic lymph nodes using OSNA - one step nucleic acid molecular assessment. OSNA - one step nucleic acid assay allows a more accurate staging of patients with colorectal cancer and standardizes lymph node assessment.

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Published

2018-11-30

How to Cite

1.
Brito MJ, Honavar M, Cipriano MA, Lopes J, Coelho H, Silva AR da, Silva M, Guimarães S, Frutuoso A, Gomes A, Barbosa E, Carlos S. Molecular Staging of Patients with Colon Cancer. The C-Closer-II Study: A Multicentre Study in Portugal. Acta Med Port [Internet]. 2018 Nov. 30 [cited 2022 Dec. 7];31(11):661-9. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/9696

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Section

Original