Abstract
BackgroundOne-step nucleic acid amplification (OSNA) analysis is a molecular diagnostic technique for lymph node metastases (LNMs) by quantifying cytokeratin 19(CK 19) mRNA. We aim to evaluate the intraoperative diagnostic accuracy of OSNA assay for LNMs of papillary thyroid carcinoma (PTC).MethodsPubMed, Embase, Cochrane Library, and Web of Science databases were searched to retrieve related literature. A meta-analysis was performed using STATA11.0, Meta-Disc 1.4 and RevMan 5.3.ResultsThis meta-analysis included six studies involving 987 lymph nodes from 194 patients. The pooled sensitivity, specificity, and area under the summary receiver-operating characteristic curve (AUC) of OSNA for detecting LNM were 0.88, 0.90, and 0.95, respectively.ConclusionOSNA assay is an accurate molecular diagnosis for intraoperative detection of lymph node metastasis in PTC.
Highlights
Papillary thyroid carcinoma (PTC) is the most common endocrine-related malignances
The American Thyroid Association (ATA) recommends that therapeutic central compartment lymph node dissection (LND) should be performed when lymph node metastases (LNM) has been confirmed before or during surgery, and prophylactic LND should be performed in high-risk patients with stages T3 and T4 of the TNM classification [8]
The inclusion criteria were as follows: [1] patients included in studies had a confirmed pathologic diagnosis of PTC; [2] evaluating the diagnostic accuracy of One-step nucleic acid amplification (OSNA) for LNM; [3] postoperative hematoxylin-eosin (HE) staining was used as the gold standard in lymph node evaluation; [4] providing sufficient information for calculating values of true-positive (Tp), false-positive (Fp), false-negative (Fn), and true-negative (Tn)
Summary
PTC has an excellent prognosis, its incidence of central compartment lymph node metastases (LNM) is relatively high, reported to be 20-90% [1–3]. Whether the surgical treatment of PTC requires central neck compartment lymph node dissection (LND) is a controversial topic because of the potential risks of hypocalcemia and recurrent laryngeal nerve injury and the doubtful prognostic benefits [4–7]. The American Thyroid Association (ATA) recommends that therapeutic central compartment LND should be performed when LNM has been confirmed before or during surgery, and prophylactic LND should be performed in high-risk patients with stages T3 and T4 of the TNM classification [8]. Accurate identification of neck LNM is essential for selecting the appropriate surgical plan for the treatment of PTC patients. We aim to evaluate the intraoperative diagnostic accuracy of OSNA assay for LNMs of papillary thyroid carcinoma (PTC)
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