Salomon Georg, Hess Thorsten, Erbersdobler Andreas, Eichelberg Christian, Greschner Siegfried, Sobchuk Andrey N, Korolik Anna K, Nemkovich Nicolai A, Schreiber Jürgen, Herms Martin, Graefen Markus, Huland Hartwig
Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
Eur Urol. 2009 Feb;55(2):376-83. doi: 10.1016/j.eururo.2008.02.022. Epub 2008 Mar 7.
To determine the feasibility of ex situ prostate cancer detection by triple spectroscopy. A positive surgical margin following radical prostatectomy is an adverse factor for recurrence-free survival. Detection of residual cancer cells in vivo would be the most useful, allowing the resection of such tissue during the procedure. Aside from the use of frozen sections, the ability to detect positive surgical margins is limited. Laser-induced autofluorescence, white-light remission, and high-frequency impedance spectroscopy are methods that allow discrimination of tissues of different dignities based on their specific signature. We tested whether the combination of these techniques can differentiate malignant and benign prostate tissue ex vivo.
In preparation for future in vivo measurements, an ex vivo study was performed to detect characteristics of prostate tissue. Ninety-five tissue samples from 32 patients undergoing radical prostatectomy for clinically localized prostate cancer were taken immediately after removal of the prostate and stored in liquid nitrogen. Tissue samples were thawed for laser-induced autofluorescence, white-light remission, and high-frequency impedance spectroscopy. Based on these results, a computerized algorithm was developed for tissue differentiation.
The statistical analysis of laser-induced autofluorescence and white-light remission data demonstrated a differentiation of benign and malignant prostate tissue with a sensitivity of 87.5% and a specificity of 87.3%. By adding the acquired high-frequency impedance data to the statistical analysis, sensitivity and specificity were increased to 93.8% and 92.4%.
A highly accurate differentiation of prostate tissue was achieved in an ex vivo model. In vivo studies need to be performed to evaluate whether this technique can be successful in an intraoperative setting to detect positive surgical margins.
确定通过三重光谱法进行体外前列腺癌检测的可行性。根治性前列腺切除术后手术切缘阳性是无复发生存的不利因素。在体内检测残留癌细胞将是最有用的,这样可以在手术过程中切除此类组织。除了使用冰冻切片外,检测手术切缘阳性的能力有限。激光诱导自体荧光、白光反射和高频阻抗光谱法是基于不同组织的特定特征来区分不同性质组织的方法。我们测试了这些技术的组合能否在体外区分恶性和良性前列腺组织。
为未来的体内测量做准备,进行了一项体外研究以检测前列腺组织的特征。从32例因临床局限性前列腺癌接受根治性前列腺切除术的患者中获取95个组织样本,在前列腺切除后立即取出并储存在液氮中。将组织样本解冻以进行激光诱导自体荧光、白光反射和高频阻抗光谱分析。基于这些结果,开发了一种用于组织区分的计算机算法。
对激光诱导自体荧光和白光反射数据的统计分析表明,良性和恶性前列腺组织的区分灵敏度为87.5%,特异性为87.3%。将获取的高频阻抗数据添加到统计分析中后,灵敏度和特异性分别提高到93.8%和92.4%。
在体外模型中实现了前列腺组织的高度准确区分。需要进行体内研究以评估该技术在术中检测手术切缘阳性方面是否能够成功。