Molecular margins in head and neck cancer: Current techniques and future directions.

Molecular margins in head and neck cancer: Current techniques and future directions.
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DOI:
10.1016/j.oraloncology.2020.104893
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发表时间:
2020-11
期刊:
影响因子:
4.8
通讯作者:
Puram SV
Puram SV
中科院分区:
医学2区
文献类型:
--
作者:
Stepan KO;Li MM;Kang SY;Puram SV

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完整的肿瘤切除和清晰的手术边缘仍然是肿瘤头颈外科手术的中心原则。当无法获得明确的切缘时,局部区域复发率和存活率都明显更差。目前的临床实践依赖于术中使用冰冻切片,然后在手术后进行传统的组织病理学分析来评估手术切缘。然而,随着对肿瘤生物学理解的提高和技术的进步,出现了在分子水平上分析边缘的新技术。这种分子边缘分析询问组织的遗传、表观遗传或蛋白质组变化,这些变化可能掩盖了肿瘤的存在或标准组织病理学技术没有捕捉到的侵袭性特征。术中,这一信息可以用来指导切除,而术后,它可能有助于对患者进行分层辅助治疗。本文对分子边缘分析的研究现状进行了综述,并对未来的研究方向进行了展望。
Complete tumor extirpation with clear surgical margins remains a central tenet of oncologic head and neck surgery. Rates of locoregional recurrence and survival are both significantly worse when clear margins are unable to be obtained. Current clinical practice relies on the use of frozen sections intra-operatively, followed by traditional histopathologic analysis post-operatively to assess the surgical margin. However, with improved understanding of tumor biology and advances in technology, new techniques have emerged to analyze margins at a molecular level. Such molecular margin analysis interrogates tissue for genetic, epigenetic, or proteomic changes that may belie tumor presence or aggressive features not captured by standard histopathologic techniques. Intra-operatively, this information may be used to guide resection, while post-operatively, it may help to stratify patients for adjuvant treatment. In this review, we summarize the current state of molecular margin analysis and describe directions for future research.
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