One-step nucleic acid amplification (OSNA): where do we go with it?

Abstract

The one-step nucleic acid amplification (OSNA) assay was initially developed for the intraoperative assessment of sentinel lymph node metastases in breast cancer. This assay measures cytokeratin 19 (CK19) mRNA copy number and is widely used in hospitals. The results of the IBCSG 23-01, ACOSOG Z0011, and AMAROS trials demonstrated that no further axillary dissection is required for patients with sentinel lymph nodes that tested positive for cancer, which has led to a decreasing trend in the need for intraoperative assessment of lymph nodes. Here, I review studies relevant to OSNA and discuss perspectives on future applications of OSNA in cancer surgery. The studies reviewed were identified by carrying out a search on PubMed for all articles pertaining to OSNA and published prior to the end of June 2016 using the keywords "OSNA" or "one-step nucleic acid amplification" in the title or abstract. Method comparison studies between OSNA and pathological assessment for the detection of lymph node metastasis in breast cancer revealed that in a pooled assessment OSNA had a high specificity (94.8 %), high concordant rate (93.8 %), and a negative predictive value (97.6 %). Similar results have been found for gastric, colorectal, and lung cancers in multicenter studies. These results demonstrate that OSNA can serve as an alternative method to pathological assessment for examining lymph node metastasis. Multicenter prospective studies with a large sample size are needed to definitively reveal the superiority of OSNA over pathological assessment to predict prognosis. Technical refinements to improve the assay are essential to its further development as a new standard for testing in place of pathological examination.

One‐step nucleic acid amplification vs ultrastaging in the detection of sentinel lymph node metastasis in endometrial cancer patients

“…In our study, the OSNA method compared with ultrastaging led to the detection of a higher number of metastatically involved SLNs, with the consequent upstaging of 20.69% more patients. In the case of breast and colorectal cancers, this method proved itself sufficient in the past and is already accepted as a standard method in routine clinical practice . The utilisation of the OSNA method in combination with SLNM techniques in EC patients holds great promise for the future for the highly sensitive detection of metastatically involved lymph nodes and the relevant application of adjuvant treatment.…”

“…in routine clinical practice. 26 The utilisation of the OSNA method in combination with SLNM techniques in EC patients holds great promise for the future for the highly sensitive detection of metastatically involved lymph nodes and the relevant application of adjuvant treatment. The next step of the study is to apply this method for examining SLNs in EC patients should focus on the inclusion of the examination of the whole SLN without indirect histological control.…”

Application of loop-mediated isothermal amplification of DNA for diagnosis of prostate cancer micrometastases in the lymph nodes

“…Ведутся исследования применения OSNA при других злокачественных патологиях, таких как рак желудка [11], легкого [12], щитовидной железы [13]. Чувствительность метода для определения метастазов в ЛУ в данных исследованиях варьирует от 81,8 до 88,9 %, а специфичностьот 87,5 до 100 % [14].…”

Loop-mediated isothermal amplification: an effective method for express-diagnostics of cancer

“…Поэтому обнаружение цитокератина 19 в ЛУ является признаком присутствия в нем опухолевых клеток эпителиального происхождения. Метод был разработан для детекции метастазов рака молочной железы и с тех пор успешно применен для детекции метастазов других опухолей эпителиального происхождения, в частности колоректального рака, немелкоклеточного рака легких, рака матки и щитовидной железы [21][22][23][24].…”

“…Чувствительность и специфичность относительно морфологического исследования составили 94 и 93 %. Такие же высокие значения были получены ранее для других видов опухолей [24]. Таким образом, метод применим и для рака предстательной железы.…”