Folate Receptor Near-Infrared Optical Imaging Provides Sensitive and Specific Intraoperative Visualization of Nonfunctional Pituitary Adenomas
Folate Receptor Near-Infrared Optical Imaging Provides Sensitive and Specific Intraoperative Visualization of Nonfunctional Pituitary Adenomas
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DOI：
10.1093/ons/opy034
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发表时间：
2019-01-01
影响因子：
2.3
通讯作者：
Lee, John Y. K.
中科院分区：
文献类型：
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作者：
Cho, Steve S.;Zeh, Ryan;Lee, John Y. K.
背景技术背景：手术切除是治疗无功能性垂体腺瘤的主要方法，但难以在所有病例中实现全切除。NF腺瘤过表达叶酸受体α（FR α）。目的：为了验证我们可以使用近红外（NIR）成像对FR α进行高灵敏度和特异性术中检测NF腺瘤的假设：14例NF垂体腺瘤患者术前输注叶酸类似物NIR染料OTL 38。在切除腺瘤的过程中记录每个肿瘤的NIR荧光信号背景比（SBR）。未根据是否存在荧光修改手术范围。进行免疫组织化学以评估所有标本中的FR α表达。术后进行磁共振成像（MRI），以评估残留neoplasia.RESULTS：9腺瘤过表达FR α和荧光与近红外SBR为3.2 +/- 0.52，而5个非FR α-过表达腺瘤荧光与SBR为1.5 +/- 0.21。线性回归显示，术中SBR和FR α表达之间存在显著相关性（P值
BACKGROUND: Surgical resection is the primary treatment for nonfunctional (NF) pituitary adenomas, but gross-total resection is difficult to achieve in all cases. NF adenomas overexpress folate receptor alpha (FR alpha).OBJECTIVE: To test the hypothesis that we could target FR alpha for highly sensitive and specific intraoperative detection of NF adenomas using near-infrared (NIR) imaging.METHODS: Fourteen patients with NF pituitary adenoma were infused with the folate analog NIR dye OTL38 preoperatively. NIR fluorescence signal-to-background ratio (SBR) was recorded for each tumor during resection of the adenomas. Extent of surgery was not modified based on the presence or absence of fluorescence. Immunohistochemistry was performed to assess FR alpha expression in all specimens. Magnetic resonance imaging (MRI) was performed postoperatively to assess residual neoplasm.RESULTS: Nine adenomas overexpressed FR alpha and fluoresced with a NIR SBR of 3.2 +/- 0.52, whereas the 5 non-FR alpha-overexpressing adenomas fluoresced with an SBR of 1.5 +/- 0.21. Linear regression demonstrated a significant correlation between intraoperative SBR and the FR alpha expression (P-value