Samkoe Kimberley S, Bates Brent D, Elliott Jonathan T, LaRochelle Ethan, Gunn Jason R, Marra Kayla, Feldwisch Joachim, Ramkumar Dipak B, Bauer David F, Paulsen Keith D, Pogue Brian W, Henderson Eric R
1 Department of Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
2 Geisel School of Medicine, Dartmouth College, Hanover, NH, USA.
Cancer Control. 2018 Jan-Mar;25(1):1073274817752332. doi: 10.1177/1073274817752332.
The excision of tumors by wide local excision is challenging because the mass must be removed entirely without ever viewing it directly. Positive margin rates in sarcoma resection remain in the range of 20% to 35% and are associated with increased recurrence and decreased survival. Fluorescence-guided surgery (FGS) may improve surgical accuracy and has been utilized in other surgical specialties. ABY-029, an anti-epidermal growth factor receptor Affibody molecule covalently bound to the near-infrared fluorophore IRDye 800CW, is an excellent candidate for future FGS applications in sarcoma resection; however, conventional methods with direct surface tumor visualization are not immediately applicable. A novel technique involving imaging through a margin of normal tissue is needed. We review the past and present applications of FGS and present a novel concept of indirect FGS for visualizing tumor through a margin of normal tissue and aiding in excising the entire lesion as a single, complete mass with tumor-free margins.
通过广泛局部切除来切除肿瘤具有挑战性，因为必须在不直接观察肿块的情况下将其完全切除。肉瘤切除的切缘阳性率仍在20%至35%之间，并且与复发增加和生存率降低相关。荧光引导手术（FGS）可能会提高手术准确性，并且已在其他外科专业中得到应用。ABY-029是一种与近红外荧光团IRDye 800CW共价结合的抗表皮生长因子受体亲和分子，是未来FGS在肉瘤切除中应用的极佳候选物；然而，直接观察肿瘤表面的传统方法并不立即适用。需要一种通过正常组织边缘进行成像的新技术。我们回顾了FGS的过去和当前应用，并提出了一种间接FGS的新概念，即通过正常组织边缘可视化肿瘤，并帮助将整个病变作为一个无瘤边缘的完整肿块切除。
