Shift in paradigm in lymph node diagnostics: from traditional diagnosis based on paraffin-embedded sections to quantitative molecular single-cell analysis

The therapy decision (e.g. type of surgery, radiation therapy, need for chemotherapy) for a particular patient also depends on the spread of the cancer in the body. This is why lymph nodes are resected during surgical removal of a solid tumor (e.g. breast or lung cancer), namely to prepare tissue slices and then perform microscopy to detect or exclude the spreading of tumor cells. We are working to develop innovative approaches, aiming to replace the over 100-year-old slice-based diagnostic procedure that allows tumor cells to be detected in the different section planes selected at random, with an immunocytological analysis of the whole sample. In addition to an exact quantification of tumor infestation, this will furthermore enable subsequent genetic analysis, allowing selection of the most suitable therapy for each patient in the future.

Publications

1. Ulmer A, Dietz K, Hodak I, Polzer B, Scheitler S, Yildiz M, Czyz Z, Lehnert P, Fehm T, Hafner C, Schanz S, Röcken M, Garbe C, Breuninger H, Fierlbeck G, Klein CA. Quantitative measurement of melanoma spread in sentinel lymph nodes and survival. PLoS Med 2014; 11(2): e1001604
2. Cucuruz B, Dango S, Jurinovic V, Mayer O, Follo M, Böhm J, Freudenberg N, Elze M, Sienel W, Klein CA, Passlick B, Polzer B. MAGE qPCR improves sensitivity and accuracy of EBUS-TBNA for the detection of lymphatic cancer spread. J Thorac Oncol 2012; 7 (4): 690-7.