Accurate and rapid novel genetic diagnosis for detection of sentinel lymph node metastasis in breast cancer patients
A partir de 264 ganglions sentinelles prélevés sur 131 patientes atteintes d'un cancer du sein, cette étude évalue la sensibilité, la spécificité et la rapidité d'un test reposant sur la mesure conjointe du nombre de copies de l'ARN messager de la cytokératine-19 et de l'antigène carcinoembryonnaire pour détecter des métastases
Background : The transcription-reverse transcription concerted reaction (TRC) test is a novel molecular-based procedure, which can assess nodal metastasis accurately and quickly. We examined the usefulness of the TRC test with a double marker, cytokeratin 19 (CK19) and carcinoembryonic antigen (CEA) mRNA, to detect sentinel lymph nodes (SLN) metastasis in breast cancer patients.
Methods : A total of 264 SLNs from 131 breast cancer patients were assigned to a training set (109 SLNs from 50 patients) and validation set (155 SLNs from 81 patients). Cytokeratin 19 and CEA mRNA were detected by TRC tests, and the sensitivity and specificity of the SLN metastasis between the TRC and histology cohorts were compared.
Results : Mean copy numbers of CK19 and CEA by TRC tests were increased according to the metastatic size. In the training set, TRC test showed 100% sensitivity, specificity and concordance rates against the permanent histopathology test. In the validation set, sensitivity was 97.1%, specificity was 99.2% and the concordance rate was 99.4%.
Conclusion : Our results showed that the detection of CK19 and CEA mRNA using the TRC test is, an accurate and rapid method for detection of SLN metastasis and can be applied as an intraoperative molecular diagnosis in breast cancer patients.
British Journal of Cancer , résumé, 2011