Tyndall National Institute, Lee Maltings, Dyke Parade, Cork, T12 R5CP, Ireland.
Department of Physics, University College Cork, College Road, Cork, T12 K8AF, Ireland.
Analyst. 2023 Dec 18;149(1):88-99. doi: 10.1039/d3an00261f.
Colorectal cancer (CRC) is the third most common and second most deadly type of cancer worldwide, representing 11.3% of the diagnosed cancer cases and resulting in 10.2% (0.88 million) of the cancer related deaths in 2020. CRCs are typically detected at the late stage, which leads to high mortality and morbidity. Mortality and poor prognosis are partially caused by cancer recurrence and postoperative complications. Patient survival could be increased by improving precision in surgical resection using accurate surgical guidance tools based on diffuse reflectance spectroscopy (DRS). DRS enables real-time tissue identification for potential cancer margin delineation through determination of the circumferential resection margin (CRM), while also supporting non-invasive and label-free approaches for laparoscopic surgery to avoid short-term complications of open surgery as suitable. In this study, we have estimated the scattering properties and chromophore concentrations based on 2949 DRS measurements of freshly excised specimens of 47 patients, and used this estimation to classify normal colorectal wall (CW), fat and tumor tissues. DRS measurements were performed with fiber-optic probes of 630 μm source-detector distance (SDD; probe 1) and 2500 μm SDD (probe 2) to measure tissue layers ∼0.5-1 mm and ∼0.5-2 mm deep, respectively. By using the 5-fold cross-validation of machine learning models generated with the classification and regression tree (CART) algorithm, we achieved 95.9 ± 0.7% sensitivity, 98.9 ± 0.3% specificity, 90.2 ± 0.4% accuracy, and 95.5 ± 0.3% AUC for probe 1. Similarly, we achieved 96.9 ± 0.8% sensitivity, 98.9 ± 0.2% specificity, 94.0 ± 0.4% accuracy, and 96.7 ± 0.4% AUC for probe 2.
结直肠癌（CRC）是全球第三大常见和第二大致命癌症类型，占诊断癌症病例的 11.3%，导致 2020 年 10.2%（88 万）与癌症相关的死亡。CRC 通常在晚期被发现，这导致了高死亡率和发病率。死亡率和预后不良部分是由于癌症复发和术后并发症所致。通过使用基于漫反射光谱（DRS）的精确手术指导工具提高手术切除的精度，可以提高患者的生存率。DRS 通过确定圆周切缘（CRM），实现实时组织识别，以潜在地划定癌症边缘，同时还支持非侵入性和无标记的腹腔镜手术方法，以避免开放式手术的短期并发症。在这项研究中，我们根据 47 名患者的 2949 次新鲜切除标本的 DRS 测量结果，估计了散射特性和发色团浓度，并使用该估计值对正常结直肠壁（CW）、脂肪和肿瘤组织进行分类。DRS 测量使用光纤探头进行，源-探测器距离（SDD）分别为 630 μm（探头 1）和 2500 μm（探头 2），以分别测量深度约为 0.5-1 mm 和 0.5-2 mm 的组织层。通过使用分类和回归树（CART）算法生成的机器学习模型的 5 倍交叉验证，我们分别获得了 95.9%±0.7%、98.9%±0.3%、90.2%±0.4%和 95.5%±0.3%的探针 1 灵敏度、96.9%±0.8%、98.9%±0.2%、94.0%±0.4%和 96.7%±0.4%的探针 2 特异性、95.9%±0.7%和 90.2%±0.4%的探针 1 准确性和 96.9%±0.8%。
