One-Step Nucleic Acid Amplification Assay for Detection of Axillary Lymph Node Metastases in Breast Cancer Patients Treated with Neoadjuvant Chemotherapy

2017 Fiscal Year Final Research Report

• Project/Area Number: 15K10051
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: General surgery
• Research Institution: Osaka University
• Principal Investigator: Shimazu Kenzo 大阪大学, 医学系研究科, 講師 (30448039)
• Research Collaborator: TAKAMOTO Kaori
• Project Period (FY): 2015-04-01 – 2018-03-31
• Keywords: 乳癌 / センチネルリンパ節生検 / 術前化学療法

Outline of Final Research Achievements

Sentinel lymph nodes (SLNs), and non-SLNs from 88 breast cancer patients treated with NAC were examined by means of histology and OSNA. The diagnostic accuracy, sensitivity, and specificity of OSNA for were 87.8, 75.0, and 91.2 % respectively for SLNs, and the corresponding values were and 95.1, 97.3, and 94.6 % for non-SLNs. The diagnostic accuracy of OSNA was significantly lower for SLNs than for non-SLNs (P = 0.021), which was attributable to the low sensitivity for detection of micrometastases (micromets) due to lower CK19 mRNA expression detected by in situ hybridization (ISH) in SLN micromets than in non-SLN micromets. For primary breast tumors, CK19 mRNA expression showed a significant reduction after NAC (P = 0.040). The findings obtained with CK19 mRNA ISH suggest that most SLN micromets cannot be detected by OSNA due to the reduced expression of CK19 mRNA induced by NAC.

Free Research Field

乳腺内分泌外科