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Title: Cytology Smears: An Enhanced Alternative Method for Colorectal Cancer pN Stage-A Multicentre Study
Author: Diaz Mercedes, Sherley
Archilla, Iván
Lahoz, Sara
Rodrigo Calvo, María Teresa
Lopez Prades, Sandra
Tarragona, Jordi
Landolfi, Stefania
Concha, Ángel
Machado, Isidro
Maurel Santasusana, Joan
Chic, Núria
Castells, Antoni
Balaguer Prunés, Francesc
Camps, Jordi
Cuatrecasas Freixas, Miriam
Keywords: Nodes limfàtics
Càncer colorectal
Lymph nodes
Colorectal cancer
Issue Date: 9-Dec-2022
Publisher: MDPI
Abstract: Stage II colorectal cancer (CRC) recurrence remains a clinical problem. Some of these patients are true stage III CRC with a pN0 pathology stage. This large prospective multicentre cohort study aimed at evaluating the diagnostic ability of lymph node (LN) cytology smears to perform the pN stage and compare it with the conventional haematoxylin and eosin (H&E) pathology pN stage. Additionally, we used the One-Step Nucleic Acid Amplification (OSNA), a high-sensitive molecular method of LN staging. A total of 3936 fresh LNs from 217 CRC surgical specimens were examined by three methods, H&E, LN cytology smears, and OSNA. H&E detected 29% of patients with positive LNs, cytology smears 35%, and OSNA 33.2% (p < 0.0001). H&E and cytology concordantly classified 92.2% of tumours, and 88.5% between OSNA and H&E. Cytology had 96.8% sensitivity and 90.3% specificity to discriminate positive/negative patients compared to H&E (p = 0.004), and 87.3% sensitivity and 89% specificity when compared to OSNA (p = 0.56). Patients with positive LNs detected by any of the three methods had significantly worse disease-free and overall survival. We conclude that pN stage accuracy for detecting positive LNs is superior with LN cytological smears than with conventional H&E, which would enable a better pN stage and management of early-stage CRC patients.
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It is part of: Cancers, 2022, vol. 14, num.24
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ISSN: 2072-6694
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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