The surgical intelligent knife distinguishes normal, borderline and malignant gynaecological tissues using rapid evaporative ionisation mass spectrometry (REIMS).
The surgical intelligent knife distinguishes normal, borderline and malignant gynaecological tissues using rapid evaporative ionisation mass spectrometry (REIMS).
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DOI：
10.1038/s41416-018-0048-3
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发表时间：
2018-05
影响因子：
8.8
通讯作者：
Ghaem-Maghami S
中科院分区：
文献类型：
--
作者：
Phelps DL;Balog J;Gildea LF;Bodai Z;Savage A;El-Bahrawy MA;Speller AV;Rosini F;Kudo H;McKenzie JS;Brown R;Takáts Z;Ghaem-Maghami S
手术可以改善卵巢癌（OC）的生存率，但手术可能很复杂，肿瘤识别，特别是交界性卵巢肿瘤（BOT），具有挑战性。快速蒸发电离质谱（REIMS）技术通过分析电外科切割过程中的雾化组织实时报告组织组织学。用REIMS接口对组织透热过程中产生的气溶胶进行采样。组织学诊断和质谱特征复杂的脂质物种填充一个参考数据库上进行主成分，线性判别和留一个病人的交叉验证分析。共有198名患者提供了335个组织样本，产生了3384个光谱。交叉验证的OC分类与单独的正常组织是高的（97.4%的灵敏度，100%的特异性）。BOT与OC鉴别诊断的敏感性为90.5%，特异性为89.7%。使用新鲜组织进行验证可实现出色的OC检测（100%准确度）。iKnife和组织病理学家之间的组织学一致性非常好（kappa 0.84，P < 0.001，z = 3.3）。五种主要的磷脂酸（PA（36：2））和磷脂酰乙醇胺（PE（34：2））脂质种类被鉴定为与正常组织或BOT相比在OC中显著更丰富（P < 0.001，q < 0.001）。REIMS iKnife通过分析组织透热气溶胶中的质谱衍生脂质体来区分妇科组织。快速的术中妇科组织诊断可以改善组织学未知时的手术护理，从而为个人量身定制个性化手术。
Survival from ovarian cancer (OC) is improved with surgery, but surgery can be complex and tumour identification, especially for borderline ovarian tumours (BOT), is challenging. The Rapid Evaporative Ionisation Mass Spectrometric (REIMS) technique reports tissue histology in real-time by analysing aerosolised tissue during electrosurgical dissection. Aerosol produced during diathermy of tissues was sampled with the REIMS interface. Histological diagnosis and mass spectra featuring complex lipid species populated a reference database on which principal component, linear discriminant and leave-one-patient-out cross-validation analyses were performed. A total of 198 patients provided 335 tissue samples, yielding 3384 spectra. Cross-validated OC classification vs separate normal tissues was high (97·4% sensitivity, 100% specificity). BOT were readily distinguishable from OC (sensitivity 90.5%, specificity 89.7%). Validation with fresh tissue lead to excellent OC detection (100% accuracy). Histological agreement between iKnife and histopathologist was very good (kappa 0.84, P < 0.001, z = 3.3). Five predominantly phosphatidic acid (PA(36:2)) and phosphatidyl-ethanolamine (PE(34:2)) lipid species were identified as being significantly more abundant in OC compared to normal tissue or BOT (P < 0.001, q < 0.001). The REIMS iKnife distinguishes gynaecological tissues by analysing mass-spectrometry-derived lipidomes from tissue diathermy aerosols. Rapid intra-operative gynaecological tissue diagnosis may improve surgical care when histology is unknown, leading to personalised operations tailored to the individual.
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影响因子：
4.6
作者：
Dória ML;McKenzie JS;Mroz A;Phelps DL;Speller A;Rosini F;Strittmatter N;Golf O;Veselkov K;Brown R;Ghaem-Maghami S;Takats Z
通讯作者：
Takats Z
影响因子：
4.7
作者：
Chi, Dennis S.;Eisenhauer, Eric L.;Barakat, Richard R.
通讯作者：
Barakat, Richard R.
影响因子：
4.7
作者：
Chang, Suk-Joon;Hodeib, Melissa;Bristow, Robert E.
通讯作者：
Bristow, Robert E.
影响因子：
17.1
作者：
Balog, Julia;Sasi-Szabo, Laszlo;Takats, Zoltan
通讯作者：
Takats, Zoltan
DOI：
10.1186/s13058-017-0845-2
发表时间：
2017-05-23
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
St John ER;Balog J;McKenzie JS;Rossi M;Covington A;Muirhead L;Bodai Z;Rosini F;Speller AVM;Shousha S;Ramakrishnan R;Darzi A;Takats Z;Leff DR
通讯作者：
Leff DR