Scientific documents library

Axillary lymph node (ALN) status is still one of the most important prognostic factors for patients with breast cancer. As a result, an accurate and standardised determination of metastatic nodal burden within the ALN is of utmost importance when selecting the correct treatment, thus avoiding over- as well as under-treatment. Molecular analysis of sentinel lymph nodes (SLN) by quantification of CK19 mRNA expression with OSNA has shown to provide more differentiated diagnostic information compared to conventional histopathology.

There has been an increase in the use of neoadjuvant systemic therapy (NAST) in breast cancer patients in recent years. The main indications include shrinking the primary tumour, thus reducing the extent of surgery, or enabling breast conserving surgery instead of mastectomy. Moreover, it allows an assessment of the tumour’s response to systemic therapy.

Enlarged admission of breast cancer patients to neoadjuvant systemic therapy (NAST) has also led to an increased usage of OSNA for assessing sentinel lymph nodes (SLN) in eligible patients undergoing surgery after completion of therapy. In consequence, significant clinical evidence could be gained demonstrating that molecular quantification of CK19 mRNA expression by OSNA performs on the same level of accuracy in detecting nodal metastases after NAST as in the conventional adjuvant setting. Accurate SLN assessment is essential as any amount of residual metastatic disease in lymph nodes constitutes an important prognostic factor.

Lymph node status is a critical factor to predict outcomes and identify patients eligible for chemotherapy. Although histopathology based on H&E is a standard method for lymph node analysis, 30 % of patients diagnosed with negative lymph nodes develop recurrences, likely due to undetected metastases.

OSNA offers a molecular analysis by quantifying the expression of CK19 mRNA in the LN, reflecting the presence or absence of metastasis. Among 16 mRNA markers with high expression in lung cancer, CK19 reported the best performance to detect LN metastases.

Challenges in selecting the appropriate radiation therapy for your patient

Metastatic lymph node (LN) involvement is a major prognostic factor in gynaecological cancers and impacts the surgical approach as well as therapy choice. Nodal staging by systematic pelvic lymphadenectomy is associated with high risk of complications and post-surgical morbidity. Furthermore, its utility in early stage disease is challenged by the low frequency of nodal positivity and controversy about its curative effect. Sentinel lymph node biopsy (SLNB) is gaining increasing acceptance as an alternative to lymphadenectomy in the management of early stage cervical (CeC) and endometrial (EC) cancer patients, with the aim to avoid unnecessary lymphadenectomies and enable less radical surgical interventions to benefit the patient’s quality of life.

Molecular nodal staging in patients with early-stage endometrial cancer using the OSNA system – outcome of the ENDO-OSNA multicentric study

The Blood Bank mode (BB mode) is an optional mode for blood product measurement and quantification of residual cells left in the manufactured blood products. The front side of the lab information card gives an overview of blood component analysis and explains the benefit of the BB mode. The flip side presents information about sample types, technological requirements, workflow enhancements and specifications of the mode.