Cortés Jesús M, de Petris Giovanni, López José I
Quantitative Biomedicine Unit, Biocruces Research Institute, Barakaldo, Spain; Ikerbasque: The Basque Foundation for Science, Bilbao, Spain; Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa, Spain.
Department of Pathology and Laboratory Medicine, Penrose St Francis Hospital , Colorado Springs, CO , USA.
Front Med (Lausanne). 2017 Mar 6;4:25. doi: 10.3389/fmed.2017.00025. eCollection 2017.
Current sampling protocols of neoplasms along the digestive tract and in the urinary bladder have to be updated, as they do not respond to the necessities of modern personalized medicine. We show here that an adapted version of multisite tumor sampling (MSTS) is a sustainable model to overcome current deficiencies in digestive and bladder tumors when they are large enough so as to make unaffordable a total sampling. The new method is based on the divide-and-conquer algorithm and includes a slight modification of the MSTS, which proved to be useful very recently in clear cell renal cell carcinoma. This analysis confirms the usefulness of MSTS for detecting intratumor heterogeneity (ITH) in tumors arising in hollow viscera. However, MSTS does not seem to improve routine traditional sampling in detecting tumor budding, extramural venous invasion, and perineural invasion. We conclude that (1) MSTS is the best method for tumor sampling to detect ITH balancing high performance and sustainable cost, (2) MSTS must be adapted to tumor shape and tumor location for an optimal performance.
目前消化道和膀胱肿瘤的采样方案必须更新，因为它们无法满足现代个性化医疗的需求。我们在此表明，当消化道和膀胱肿瘤足够大以至于无法进行全采样时，一种改良版的多部位肿瘤采样（MSTS）是克服当前这些肿瘤采样缺陷的可持续模式。新方法基于分治算法，对MSTS进行了微调，该微调最近在透明细胞肾细胞癌中被证明是有用的。这项分析证实了MSTS在检测中空脏器肿瘤的肿瘤内异质性（ITH）方面的有效性。然而，在检测肿瘤芽生、壁外静脉侵犯和神经周围侵犯方面，MSTS似乎并未改善常规传统采样。我们得出结论：（1）MSTS是检测ITH的最佳肿瘤采样方法，能平衡高性能和可持续成本；（2）MSTS必须根据肿瘤形状和肿瘤位置进行调整以实现最佳性能。
