Automated and rapid detection of cancer in suspicious axillary lymph nodes in patients with breast cancer
| Autor: | Neesha Venkatesan, Jingping Yuan, Suzana Tulac, Chuang Chen, Mary Jo Fackler, Bradley M. Downs, Chuan gui Song, Juanjuan Li, Yufei Liu, Kejing Zhang, Timothy de Guzman, Leslie Cope, Xiuyun Zhang, Christopher J. VandenBussche, Saraswati Sukumar, Yong Han, Edwin W. Lai |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Axillary lymph nodes Sentinel lymph node Article 03 medical and health sciences 0302 clinical medicine Breast cancer Cytology Biopsy medicine Pharmacology (medical) Radiology Nuclear Medicine and imaging Prospective cohort study RC254-282 medicine.diagnostic_test business.industry Neoplasms. Tumors. Oncology. Including cancer and carcinogens Cancer Diagnostic markers medicine.disease 030104 developmental biology Fine-needle aspiration medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Radiology business Biomarkers |
| Zdroj: | NPJ Breast Cancer npj Breast Cancer, Vol 7, Iss 1, Pp 1-9 (2021) |
| ISSN: | 2374-4677 |
| DOI: | 10.1038/s41523-021-00298-6 |
| Popis: | Preoperative staging of suspicious axillary lymph nodes (ALNs) allows patients to be triaged to ALN dissection or to sentinel lymph node biopsy (SLNB). Ultrasound-guided fine needle aspiration (FNA) and cytology of ALN is moderately sensitive but its clinical utility relies heavily on the cytologist’s experience. We proposed that the 5-h automated GeneXpert system-based prototype breast cancer detection assay (BCDA) that quantitatively measures DNA methylation in ten tumor-specific gene markers could provide a facile, accurate test for detecting cancer in FNA of enlarged lymph nodes. We validated the assay in ALN-FNA samples from a prospective study of patients (N = 230) undergoing SLNB. In a blinded analysis of 218 evaluable LN-FNAs from 108 malignant and 110 benign LNs by histology, BCDA displayed a sensitivity of 90.7% and specificity of 99.1%, achieving an area under the ROC curve, AUC of 0.958 (95% CI: 0.928–0.989; P N = 72, benign, N = 53 by cytology) collected in the outpatient setting prior to neoadjuvant chemotherapy (NAC). Using the ROC-threshold determined in the prospective study, compared to cytology, BCDA achieved a sensitivity of 94.4% and a specificity of 92.5% with a ROC-AUC = 0.977 (95% CI: 0.953–1.000; P |
| Databáze: | OpenAIRE |
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