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口腔癌手术切缘的检测:动态光学对比成像的作用

Detection of surgical margins in oral cavity cancer: the role of dynamic optical contrast imaging.

作者信息

Pellionisz Peter A, Badran Karam W, Grundfest Warren S, St John Maie A

机构信息

Department of Bioengineering, Henry Samueli School of Engineering and Applied Sciences.

Department of Head and Neck Surgery, David Geffen School of Medicine.

出版信息

Curr Opin Otolaryngol Head Neck Surg. 2018 Apr;26(2):102-107. doi: 10.1097/MOO.0000000000000444.

Abstract

PURPOSE OF REVIEW

The quantity of tissue removed during an oncologic surgical procedure is not standardized and there are numerous reports of local recurrence despite histologically adequate resection margins. The oral cavity is one of the sites in the head and neck with high chances of recurrence following negative margins. To address this need, this article reviews the recent applications of Dynamic Optical Contrast Imaging (DOCI) towards both oral screening and the intraoperative evaluation of tumor margins in head and neck surgery.

RECENT FINDINGS

Human ex-vivo and in-vivo trials suggest DOCI is well tolerated, low-cost, and sensitive for differentiating cancerous from normal tissues throughout the head and neck, in addition to the oral cavity. Ex-vivo imaging of OSCC specimens generated histologically verified image contrast. Furthermore, in-vivo intraoperative results demonstrate significant potential for image-guided detection and resection of oral cavity squamous cell carcinoma (OSCC).

SUMMARY

DOCI augments tissue contrast and may enable surgeons to clinically screen patients for oral cancer, make histologic evaluations in vivo with fewer unnecessary biopsies, delineate clinical margins for tumor resection, provide guidance in the choice of biopsy sites, and preserve healthy tissue to increase the postoperative functionality and quality of life of the patient.

摘要

综述目的

肿瘤外科手术切除的组织量尚无标准化,尽管组织学切缘足够,但仍有大量局部复发的报道。口腔是头颈部术后复发几率较高的部位之一。为满足这一需求,本文综述了动态光学对比成像(DOCI)在口腔筛查以及头颈部手术中肿瘤切缘术中评估方面的最新应用。

最新发现

人体离体和体内试验表明,DOCI耐受性良好、成本低廉,除口腔外,对头颈部正常组织与癌组织的区分也很敏感。口腔鳞状细胞癌(OSCC)标本的离体成像产生了经组织学验证的图像对比度。此外,体内术中结果显示,图像引导检测和切除口腔鳞状细胞癌(OSCC)具有巨大潜力。

总结

DOCI增强了组织对比度,可能使外科医生能够对患者进行口腔癌临床筛查,减少不必要的活检进行体内组织学评估,划定肿瘤切除的临床边界,为活检部位的选择提供指导,并保留健康组织以提高患者术后功能和生活质量。

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