PDF(Pubmed)
Abstract：
OBJECTIVE: Inadequate resection margins of less than 5 mm impair local tumor control. This weak point in oncological safety is exacerbated in bone-infiltrating tumors because rapid bone analysis procedures do not exist. This study aims to assess the bony resection margin status of bone-invasive oral cancer using laser-induced breakdown spectroscopy (LIBS).
METHODS: LIBS experiments were performed on natively lasered, tumor-infiltrated mandibular cross-sections from 10 patients. In total, 5,336 spectra were recorded at defined distances from the tumor border. Resection margins < 1 mm were defined as very close, from 1-5 mm as close, and > 5 mm as clear. The spectra were histologically validated. Based on the LIBS spectra, the discriminatory power of potassium (K) and soluble calcium (Ca) between bone-infiltrating tumor tissue and very close, close, and clear resection margins was determined.
RESULTS: LIBS-derived electrolyte emission values of K and soluble Ca as well as histological parameters for bone neogenesis/fibrosis and lymphocyte/macrophage infiltrates differ significantly between bone-infiltrating tumor tissue spectra and healthy bone spectra from very close, close, and clear resection margins (p < 0.0001). Using LIBS, the transition from very close resection margins to bone-infiltrating tumor tissue can be determined with a sensitivity of 95.0%, and the transition from clear to close resection margins can be determined with a sensitivity of 85.3%.
CONCLUSIONS: LIBS can reliably determine the boundary of bone-infiltrating tumors and might provide an orientation for determining a clear resection margin.
CONCLUSIONS: LIBS could facilitate intraoperative decision-making and avoid inadequate resection margins in bone-invasive oral cancer.
METHODS: LIBS experiments were performed on natively lasered, tumor-infiltrated mandibular cross-sections from 10 patients. In total, 5,336 spectra were recorded at defined distances from the tumor border. Resection margins < 1 mm were defined as very close, from 1-5 mm as close, and > 5 mm as clear. The spectra were histologically validated. Based on the LIBS spectra, the discriminatory power of potassium (K) and soluble calcium (Ca) between bone-infiltrating tumor tissue and very close, close, and clear resection margins was determined.
RESULTS: LIBS-derived electrolyte emission values of K and soluble Ca as well as histological parameters for bone neogenesis/fibrosis and lymphocyte/macrophage infiltrates differ significantly between bone-infiltrating tumor tissue spectra and healthy bone spectra from very close, close, and clear resection margins (p < 0.0001). Using LIBS, the transition from very close resection margins to bone-infiltrating tumor tissue can be determined with a sensitivity of 95.0%, and the transition from clear to close resection margins can be determined with a sensitivity of 85.3%.
CONCLUSIONS: LIBS can reliably determine the boundary of bone-infiltrating tumors and might provide an orientation for determining a clear resection margin.
CONCLUSIONS: LIBS could facilitate intraoperative decision-making and avoid inadequate resection margins in bone-invasive oral cancer.
摘要：
目的：小于5mm的切缘不足损害局部肿瘤控制。由于不存在快速骨分析程序，因此在骨浸润性肿瘤中，肿瘤安全性的弱点会加剧。本研究旨在使用激光诱导击穿光谱（LIBS）评估骨浸润性口腔癌的骨切除边缘状态。
方法：LIBS实验是在天然激光，来自10例患者的肿瘤浸润的下颌横截面。总的来说,在距肿瘤边界的限定距离处记录5,336个光谱。切除边缘<1mm定义为非常接近,从1-5毫米接近，和>5毫米清晰。对光谱进行组织学验证。根据LIBS光谱,钾（K）和可溶性钙（Ca）在骨浸润性肿瘤组织之间的判别力非常接近，关闭,并确定了明确的切除边缘。
结果：LIBS衍生的K和可溶性Ca的电解质发射值以及骨新生/纤维化和淋巴细胞/巨噬细胞浸润的组织学参数在骨浸润肿瘤组织光谱和健康骨光谱之间存在显着差异非常接近，关闭,和清晰的切除边缘（p<0.0001）。使用LIBS，可以确定从非常接近的切除边缘到骨浸润性肿瘤组织的过渡，灵敏度为95.0％，可以确定从清晰到闭合的切除边缘的过渡，灵敏度为85.3％。
结论：LIBS可以可靠地确定骨浸润性肿瘤的边界，并可能为确定清晰的切除边缘提供方向。
结论：LIBS可以促进骨浸润性口腔癌的术中决策并避免切缘不足。
方法：LIBS实验是在天然激光，来自10例患者的肿瘤浸润的下颌横截面。总的来说,在距肿瘤边界的限定距离处记录5,336个光谱。切除边缘<1mm定义为非常接近,从1-5毫米接近，和>5毫米清晰。对光谱进行组织学验证。根据LIBS光谱,钾（K）和可溶性钙（Ca）在骨浸润性肿瘤组织之间的判别力非常接近，关闭,并确定了明确的切除边缘。
结果：LIBS衍生的K和可溶性Ca的电解质发射值以及骨新生/纤维化和淋巴细胞/巨噬细胞浸润的组织学参数在骨浸润肿瘤组织光谱和健康骨光谱之间存在显着差异非常接近，关闭,和清晰的切除边缘（p<0.0001）。使用LIBS，可以确定从非常接近的切除边缘到骨浸润性肿瘤组织的过渡，灵敏度为95.0％，可以确定从清晰到闭合的切除边缘的过渡，灵敏度为85.3％。
结论：LIBS可以可靠地确定骨浸润性肿瘤的边界，并可能为确定清晰的切除边缘提供方向。
结论：LIBS可以促进骨浸润性口腔癌的术中决策并避免切缘不足。
