Scientific documents library

The lab card illustrates the value of the CBC application and points to the advanced clinical parameter NRBC (nucleated red blood cells). The front side addresses the lab and clinical benefits, the flip side contains technical information.

A deeper insight about an activation of the immune response of patients can be acquired from newly available diagnostic parameters that support differentiation between inflammation and infection, different pathogenic causes of infection (viral versus bacterial) and different types of immune response: early innate, cellular or humoral immune response.

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.