Systematic review and meta-analysis of diagnostic accuracy of one-step nucleic acid amplification for lymph node metastases of papillary thyroid carcinoma

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PURPOSE: To evaluate the diagnostic accuracy and detection rate of lymph node metastases (LNM) in Papillary Thyroid Carcinoma (PTC) using the One-Step Nucleic Acid Amplification (OSNA) technique compared to conventional pathological methods. METHODS: A systematic search was conducted in PubMed, The Cochrane Library, Scopus, and Web of Science from May 1, 2023, to June 30, 2023, for studies published from January 1, 2005, to April 30, 2023. Observational studies assessing OSNA for LNM in PTC patients were included. Two independent reviewers performed study selection, record screening, data extraction, and quality assessment using QUADAS-2. Meta-analysis was conducted with Posit software (RStudio). RESULTS: Seven studies (2014-2021) involving 1,424 lymph nodes from 207 PTC patients were analyzed. The pooled sensitivity, specificity, and AUC of OSNA for detecting LNM were 0.905 (95% CI 0.838-0.946), 0.884 (95% CI 0.834-0.921), and 0.848, respectively. DISCUSSION: OSNA shows promising diagnostic accuracy compared to conventional pathological methods, with the potential to improve real-time lymphatic staging and aid intraoperative decision-making. Limitations include study heterogeneity and a lack of randomized controlled trials, affecting generalizability. Further research is needed to validate the long-term benefits of OSNA in clinical practice.

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