Breakthrough Test for Detecting Micrometastases During Surgery

A rapid genetic test has been developed that can help doctors evaluate lymph node biopsies for the spread of cancer at the time of surgery. This breakthrough was reported at the annual meeting of the American Association for Thoracic Surgery in San Diego. The test is the result of a research collaboration between the University of Pittsburgh School of Medicine (UPMC, PA, USA) and Cepheid (Sunnyvale, CA, USA).

Early results suggest the test is more sensitive, more accurate, and more timely than conventional methods. The test, developed by Tony Godfrey and James Luketich, both professors of surgery at UPMC, utilizes Cepheid's Smart Cycler, a commercially available instrument for rapid gene detection. Employing a variation of the polymerase chain reaction (PCR), Dr. Godfrey was able to detect in less than 30 minutes the cancer-related gene CEA in lymph node biopsies from cancer patients. The CEA gene signals the presence of micrometastases. In some cases, the accuracy of the new test surpassed histopathology.

In an ongoing prospective study, the test correctly identified two patients as positive that were deemed to be cancer-free during surgery and later were found positive by histopathology. The test also identified a patient as positive who was diagnosed as negative by both intraoperative and final histopathology methods. This patient experienced disease recurrence several months after surgery. Similar results were obtained in a retrospective study.

"To properly treat cancer patients, lymph nodes need to be evaluated during surgery,” said Dr. Godfrey. "Unfortunately, current intraoperative methods are not sensitive enough to detect micrometastatic disease. As a result, many patients are either under-treated or undergo a second operation.”





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