• lung cancer
• micrometastases
• NSCLC
• OSNA

Lung cancer is one of the leading causes of death worldwide. Surgical treatment (anatomical lung resection and systematic lymphadenectomy) is the gold standard for patients with early-stage non-small cell lung cancer (NSCLC). Prognosis depends on the pathological stage and lymph node involvement. Post-surgical recurrences occur in 30-40% of cases, often due to lymph node micrometastases undetected by standard diagnostic methods.
Traditional methods (hematoxylin-eosin and immunohistochemistry) may fail to identify lymph node micrometastases, potentially causing disease down-staging. The OSNA technique (One-Step Nucleic Acid Amplification), which detects CK19 (cytokeratin 19) mRNA, offers greater sensitivity, overcoming the limitations of conventional methodologies.
A pilot study conducted between March and July 2021 on 8 patients showed that OSNA detected N2 positivity in 37.5% of cases, leading to pathological up-staging in three patients. The protocol did not affect operative time or complication rates.
The presented prospective study, approved by the ethics committee, plans to enroll 130 patients to compare OSNA with traditional techniques in terms of accuracy in detecting micrometastases, impact on lymph node staging, and the potential benefit of adjuvant treatments.