Real-time surveillance of surgical margins via ICG-based near-infrared fluorescence imaging in patients with OSCC
Real-time surveillance of surgical margins via ICG-based near-infrared fluorescence imaging in patients with OSCC
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DOI：
10.1186/s12957-020-01874-z
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发表时间：
2020-05-15
影响因子：
3.2
通讯作者：
Wang, Yuxin
中科院分区：
文献类型：
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作者：
Pan, Jiongru;Deng, Han;Wang, Yuxin
背景局部复发是口腔鳞状细胞癌（OSCC）患者死亡的主要原因。本研究评估了近红外荧光（NIF）成像和光谱监测手术边缘手术中的口腔鳞癌。方法首先通过细胞学和动物实验验证NIF成像和光谱技术监测手术切缘的可行性。然后，20例OSCC患者被纳入临床试验。在注射0.75 mg/kg吲哚菁绿色（ICG）后6 - 8 h，所有患者均接受了NIF成像手术。在手术期间，获取NIF图像和定量荧光强度以监测手术切缘。结果在细胞学和动物实验中，应用NIF成像和光谱技术对手术切缘进行监测是可行的。在所有患者的原发性肿瘤中检测到荧光。肿瘤、瘤周和正常组织的荧光强度分别为398.863 ± 151.47、278.52 ± 84.89和274.5 ± 100.93任意单位（AU）（P <0.05）。肿瘤与瘤周组织和正常组织的SBR分别为1.45 ± 0.36和1.56 ± 0.41。原发肿瘤切除后，4例（4/20）患者伤口出现异常荧光，2例（2/20）患者经病理检查证实有癌细胞残留。结论NIF成像在口腔鳞癌根治性切除术中具有重要的辅助价值。在肿瘤切除前，我们可以利用ICG NIF成像产生的荧光边缘来确定手术边缘。此外，在肿瘤块被去除后，肿瘤床和体外标本的ICG NIF成像也可以快速评估手术切缘的状态。
Background Local recurrence is the main cause of death among patients with oral squamous cell carcinoma (OSCC). This study assessed near-infrared fluorescence (NIF) imaging and spectroscopy to monitor surgical margins intraoperatively for OSCC. Methods Cytological and animal experiments were first performed to confirm the feasibility of monitoring surgical margins with NIF imaging and spectroscopy. Then, 20 patients with OSCC were included in the clinical trials. At 6-8 h after 0.75 mg/kg indocyanine green (ICG) injection, all patients underwent surgery with NIF imaging. During the surgery, both NIF images and quantified fluorescence intensity were acquired to monitor the surgical margins. Results In cytological and animal experiments, the results showed it was feasible to monitor surgical margins with NIF imaging and spectroscopy. Fluorescence was detected in primary tumors in all patients. The fluorescence intensities of the tumor, peritumoral, and normal tissues were 398.863 +/- 151.47, 278.52 +/- 84.89, and 274.5 +/- 100.93 arbitrary units (AUs), respectively (P < 0.05). The SBR of tumor to peritumoral tissue and normal tissues was computed to be 1.45 +/- 0.36 and 1.56 +/- 0.41, respectively. After primary tumor excision, the wounds showed abnormal fluorescence in four patients (4/20), and residual cancer cells were confirmed by pathological examination in two patients (2/20). Conclusion These findings confirmed the complementary value of NIF imaging during radical tumor resection of OSCC. Before tumor resection, we could utilize the fluorescence margin produced by ICG NIF imaging to determine the surgical margin. Moreover, after tumor blocks were removed, the status of surgical margin could also be evaluated rapidly by ICG NIF imaging of tumor bed and in vitro specimens.