TY - JOUR T1 - Assessment of suitability of the one step nucleic acid amplification (OSNA) assay as an intraoperative procedure for detection of metastasis in sentinel lymph nodes of breast cancer JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 1032 LP - 1037 DO - 10.1136/jclinpath-2014-202361 VL - 67 IS - 12 AU - Ana Richelia Jara-Lazaro AU - Ilyana Huda Mohamed Hussain AU - Aye Aye Thike AU - Chow Yin Wong AU - Gay Hui Ho AU - Wei Sean Yong AU - Kong Wee Ong AU - Preetha Madhukumar AU - Benita Kiat Tee Tan AU - Chung Lie Oey AU - Jacqueline Siok Gek Hwang AU - Puay Hoon Tan Y1 - 2014/12/01 UR - http://jcp.bmj.com/content/67/12/1032.abstract N2 - Aim We aimed to assess the one step nucleic acid amplification (OSNA) assay as an intraoperative method in comparison with frozen sections (FS) for detection of metastasis in sentinel lymph nodes (SLNs) of breast cancer. Method 100 SLNs from patients with breast carcinoma were enrolled within a 3-month period. Alternate 2 mm node slices were subjected to routine FS, and later to permanent histology, and the rest for automated molecular detection of CK19 mRNA using OSNA. FS and OSNA findings were compared with permanent histology results. Difference in turnaround time was also noted. Results With permanent histology as gold standard, OSNA was discrepant in 8 of 98 (3 false negative, 5 false positive) included SLNs whereas FS had 2 false negative cases. FS had higher sensitivity (89%, p=<0.001), specificity (100%, p=0.001) and concordance rate (98%) than OSNA (83%, 94% and 92%, respectively). FS showed almost perfect agreement (κ=0.929) whereas OSNA showed substantial agreement (κ=0.740) when compared with permanent histology. OSNA turnaround time was twice longer (mean of 47.7 min) than FS. Conclusions Automation of SLN assessment using OSNA is a potentially useful intraoperative diagnostic tool with acceptable accuracy. Discordant findings in this study may be due to sampling allocation. Since OSNA is more time-consuming, its practical advantage over routine FS requires further study in view of current technical workflow considerations. ER -