Validation of Sentinel Lymph Node Theory and Application of Molecular Pathology Diagnosis for Personalized Medicine in Gynecologic Cancer Surgery

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K09757
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: Kagoshima University
• Principal Investigator: Togami Shinichi 鹿児島大学, 医歯学域医学系, 講師 (20644769)
• Co-Investigator(Kenkyū-buntansha): 小林 裕明 鹿児島大学, 医歯学域医学系, 教授 (70260700)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 子宮頸癌 / 子宮体癌 / センチネルリンパ節生検 / OSNA法

Outline of Final Research Achievements

Using lymph nodes removed during uterine cancer surgery, the concordance rate between the OSNA assay and the pathological diagnosis was evaluated. The sensitivity of the OSNA assay for cervical cancer was 80%, specificity 97.7%, and concordance with pathology 95.9%. The sensitivity of the OSNA assay for endometrial cancer was 85.7%, specificity 93.3%, and concordance rate 92.5%. Discordance was observed in two cases of cervical cancer (OSNA positive x pathology negative and vice versa), which was thought to be due to the localization of micro-metastases. Discordance was observed in 5 cases of endometrial cancer (OSNA positive x pathology negative) in 4 cases, but pathologic micro-metastases were confirmed in all cases by ultra-staging of the specimens. The remaining case (OSNA negative x pathology positive) was thought to be due to the fact that the primary tumor was CK19 negative.

Free Research Field

婦人科腫瘍

Academic Significance and Societal Importance of the Research Achievements

本研究にて子宮がんでもSNの術中転移診断をOSNA法で代用できる可能性が示唆された。そのため、従来は摘出したSNを2mm間隔にスライスして術中に病理医が手術中という限られた時間内に多くの切片の転移判定を行う代わりにOSNA法での診断が可能となる。術中にリンパ節転移の有無を診断することは、病理にとってかなり負担であるが、その負担が軽減される。また、OSNA法にて転移陰性であれば骨盤リンパ節郭清省略が可能になり、社会的にもリンパ節郭清によって出現する下肢リンパ浮腫を軽減することが可能になり、患者QOL改善や医療費削減に大きく貢献するものである。