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Table 6 Technical comparison between histological procedures and OSNA assay

From: Detection of lymph node metastasis in lung cancer patients using a one-step nucleic acid amplification assay: a single-centre prospective study

  Histological examination OSNA assay
Tumour topography Exhaustive study of tissue topography and detection of extracapsular extension The assay do not enable the study of tumour topography, but adjacent lymph node tissue is analysed by complementary histological procedures
Morphological study Study of metastatic deposits and isolated neoplastic cells. Minimisation of false positives like benignant epithelial inclusions (exceptional in mediastinal lymph nodes) The assay do not enable the study of cellular and histological lymph node morphology
Sensibility Lower limit of detection More accuracy than histological procedures. Detection of occult micrometastasis
Whole lymph node analysis Risk of sample bias. Slow and laborious study of whole lymph node Fast, feasible and accurate whole lymph node analysis. Minimisation of false negatives
KRT19 quantification Relative quantification of KRT19 expression by digital pathology Absolute quantification of KRT19 expression that correlates with metastatic foci. The assay also allows the possibility of detecting total tumour load
Assay rapidity/Workflow Fast analysis of a single intraoperative slide (less than 15 min) Fast analysis of the whole lymph node (less than 25 min)
Methodology Standardised procedures. Immunohistochemical scores and histological examination not protocolled Normalised and standardised protocols. Unbiased results
Cost-effectiveness Higher cost of time, personnel and resources for diagnostic Lower cost-effectiveness ratio
Remnant sample Remnant samples are available for histological and molecular analysis Remaining lymph node lysates are available for subsequent molecular analysis