Feasibility and Reliability of Pancreatic Cancer Staging Using Fiberoptic Confocal Fluorescence Microscopy in Rats
Fiche publication
Date publication
novembre 2009
Auteurs
Membres identifiés du Cancéropôle Est :
Dr LINDNER Véronique, Pr MARESCAUX Jacques
Tous les auteurs :
Ignat M, Aprahamian M, Lindner V, Altmeyer A, Perretta S, Dallemagne B, Mutter D, Marescaux J
Lien Pubmed
Résumé
BACKGROUND & AIMS: Surgical management of pancreatic cancer depends on tumor resectabiliry and staging. This study evaluated a new in vivo technique, fiberoptic confocal fluorescence microscopy (FCFM), for detection and staging of pancreatic tumors in rats. METHODS: FCFM was used with a protease-activared fluorescent marker (ProSense; VisEn-Medical Inc, Woburn, MA) for in vivo imaging of solid organs (1.8-mu m resolution) in a rat model of pancreatic ductal adenocarcinoma. A preliminary study described the FCFM rendering of normal and pathologic tissues. Subsequently, 2 double-blind studies compared FCFM to standard histology in (1) detection of tumors in rat models of cancer and controls and (2) detection of nodal involvement (splenic, celiac, mesenteric, and colic) 4, 5, and 6 weeks after tumor induction vs controls. RESULTS: Tumor cells displayed a fluorescent ductal pattern compared with non-fluorescent normal pancreas or normal follicular pattern of lymph nodes (LNs). FCFM detected all the pancreatic tumors (1.7-mm mean diameter) and identified 23 LNs that contained metastases of 99 LNs examined. Standard histologic analyses resulted in 1 false-negative result in tumor detection and 2 false negatives in LN detection, whereas FCFM produced no false-negative results. Additional serial sectioning confirmed all tumors and 16 metastatic LNs, FCFM had a negative predictive value of 100% and a positive predictive value of 69.6%. CONCLUSIONS: Real-time "virtual biopsy" using FCFM detects tumors and LN metastases with 100% sensitivity and 92.2% specificity in rats, making it a reliable technique for detection and staging of pancreatic cancer.
Référence
Gastroenterology. 2009 Nov;137(5):1584-92.e1