MarginProbe®技术可对隐藏的乳腺癌细胞进行精准检测

  近日，来自纽约大学医学中心（NYU Langone Medical Center）的研究人员表示，许多癌症病人都会进行病灶切除术来移除机体早期检测到的乳腺肿瘤，但他们开发了一种新型的术中技术，其可以在移除的肿瘤组织中检测到微量的癌细胞，而这些癌细胞在手术进行期间往往是看不到的，相关研究发表于国际杂志Annals of Surgical Oncology上。

  研究者开发的这种名为MarginProbe的新技术是利用非破坏性的射频光谱技术，其在手术期间可以帮助分析被移除的癌性组织从而检测癌细胞的踪迹；如果癌细胞在被移除组织的边缘被检测到，那么外科医生就需要切除病灶位点周围的组织来确保癌细胞没有任何残留。这种新技术或可帮助患者有效监测癌细胞的趋势，对于彻底去除病灶非常关键。

  文章中，研究者对大约600名正在利用病灶切除术移除不可触及的乳腺肿瘤的患者进行研究，结果显示，相比传统的术中成像及其它评估技术而言，MarginProbe技术在移除不可见肿瘤（癌细胞）的效率是前者的3倍。研究者指出，MarginProbe在手术中的附加使用或可有效改善医生鉴别额外隐蔽的癌细胞的能力，对于改善手术成功率及癌症患者的预后也至关重要。

  在美国乳腺癌是影响女性健康的主要癌症，每年大约有28.5万名女性被诊断为这种癌症，据估计这些患者中有60%至75%会选择病灶切除术来移除癌症组织，而很多患者在术后会进行多种疗法，比如化疗或者放疗或者两者结合起来进行治疗。

  MarginProbe技术的开发对于外科医生及患者而言都是非常大的帮助，其可以在手术期间帮助医生们精准检测到隐藏在深入的癌细胞，对于改善手术成功率以及患者的寿命将带来巨大帮助。（转化医学网360zhyx.com）

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转化医学网推荐的原文摘要：

A Randomized Prospective Study of Lumpectomy Margin Assessment with Use of MarginProbe in Patients with Nonpalpable Breast Malignancies
Annals of Surgical Oncology DOI:10.1245/s10434-014-3602-0
Schnabel F1, Boolbol SK, Gittleman M, Karni T, Tafra L, Feldman S, Police A, Friedman NB, Karlan S, Holmes D, Willey SC, Carmon M, Fernandez K, Akbari S, Harness J, Guerra L, Frazier T, Lane K, Simmons RM, Estabrook A, Allweis T.
BACKGROUND:
The presence of tumor cells at the margins of breast lumpectomy specimens is associated with an increased risk of ipsilateral tumor recurrence. Twenty to 30 % of patients undergoing breast-conserving surgery require second procedures to achieve negative margins. This study evaluated the adjunctive use of the MarginProbe device (Dune Medical Devices Ltd, Caesarea, Israel) in providing real-time intraoperative assessment of lumpectomy margins.
METHODS:
This multicenter randomized trial enrolled patients with nonpalpable breast malignancies. The study evaluated MarginProbe use in addition to standard intraoperative methods for margin assessment. After specimen removal and inspection, patients were randomized to device or control arms. In the device arm, MarginProbe was used to examine the main lumpectomy specimens and direct additional excision of positive margins. Intraoperative imaging was used in both arms; no intraoperative pathology assessment was permitted.
RESULTS:
In total, 596 patients were enrolled. False-negative rates were 24.8 and 66.1 % and false-positive rates were 53.6 and 16.6 % in the device and control arms, respectively. All positive margins on positive main specimens were resected in 62 % (101 of 163) of cases in the device arm, versus 22 % (33 of 147) in the control arm (p < 0.001). A total of 19.8 % (59 of 298) of patients in the device arm underwent a reexcision procedure compared with 25.8 % (77 of 298) in the control arm (6 % absolute, 23 % relative reduction). The difference in tissue volume removed was not significant.
CONCLUSIONS:
Adjunctive use of the MarginProbe device during breast-conserving surgery improved surgeons' ability to identify and resect positive lumpectomy margins in the absence of intraoperative pathology assessment, reducing the number of patients requiring reexcision. MarginProbe may aid performance of breast-conserving surgery by reducing the burden of reexcision procedures for patients and the health care system.