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Pulmonary Endogenous Fluorescence Allows the Distinction of Primary Lung Cancer from the Perilesional Lung Parenchyma.

Gust L, Toullec A, Benoit C, Farcy R, Garcia S, Secq V, Gaubert JY, Trousse D, Orsini B, Doddoli C, Moniz-Koum H, Thomas PA, D'journo XB - PLoS ONE (2015)

Bottom Line: Respective associated wavelengths were not statistically different between perilesional lung and either primary lung cancers or non-tumoral lesions.In contrast, photobleaching was significantly more frequently observed in the targeted lesions than in the perilesional lung (p≤0,01).Inconclusive results were found for lung metastases due to the heterogeneity of this population.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery and Diseases of the Oesophagus, North Hospital, Aix-Marseille University, Marseille, France.

ABSTRACT

Background: Pre-therapeutic pathological diagnosis is a crucial step of the management of pulmonary nodules suspected of being non small cell lung cancer (NSCLC), especially in the frame of currently implemented lung cancer screening programs in high-risk patients. Based on a human ex vivo model, we hypothesized that an embedded device measuring endogenous fluorescence would be able to distinguish pulmonary malignant lesions from the perilesional lung tissue.

Methods: Consecutive patients who underwent surgical resection of pulmonary lesions were included in this prospective and observational study over an 8-month period. Measurements were performed back table on surgical specimens in the operative room, both on suspicious lesions and the perilesional healthy parenchyma. Endogenous fluorescence signal was characterized according to three criteria: maximal intensity (Imax), wavelength, and shape of the signal (missing, stable, instable, photobleaching).

Results: Ninety-six patients with 111 suspicious lesions were included. Final pathological diagnoses were: primary lung cancers (n = 60), lung metastases of extra-thoracic malignancies (n = 27) and non-tumoral lesions (n = 24). Mean Imax was significantly higher in NSCLC targeted lesions when compared to the perilesional lung parenchyma (p<0,0001) or non-tumoral lesions (p<0,0001). Similarly, photobleaching was more frequently found in NSCLC than in perilesional lung (p<0,0001), or in non-tumoral lesions (p<0,001). Respective associated wavelengths were not statistically different between perilesional lung and either primary lung cancers or non-tumoral lesions. Considering lung metastases, both mean Imax and wavelength of the targeted lesions were not different from those of the perilesional lung tissue. In contrast, photobleaching was significantly more frequently observed in the targeted lesions than in the perilesional lung (p≤0,01).

Conclusion: Our results demonstrate that endogenous fluorescence applied to the diagnosis of lung nodules allows distinguishing NSCLC from the surrounding healthy parenchyma and from non-tumoral lesions. Inconclusive results were found for lung metastases due to the heterogeneity of this population.

No MeSH data available.


Related in: MedlinePlus

Difference of Mean Imax in absolute value of non-tumoural lesions and non small cell lung cancer with the associated perilesional lung parenchyma.Each dot was calculated with the mean Imax of the five measurements performed on the non-tumoural lesions (n = 24) and NSCLC (n = 60). The black bar corresponds to the median value of each subgroup. NSCLC: Non Small Cell Lung Cancer. NT: Non tumoural.
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pone.0134559.g003: Difference of Mean Imax in absolute value of non-tumoural lesions and non small cell lung cancer with the associated perilesional lung parenchyma.Each dot was calculated with the mean Imax of the five measurements performed on the non-tumoural lesions (n = 24) and NSCLC (n = 60). The black bar corresponds to the median value of each subgroup. NSCLC: Non Small Cell Lung Cancer. NT: Non tumoural.

Mentions: In ultimately proven NSCLC patients, mean Imax was of 4485 ± 2477 (range 45–17755) in the targeted lesion, whereas it was of 2228,27 ±1896 (range 45–10255) in the perilesional lung parenchyma. For the 32 samples for which inflation of perilesional lung was possible, mean Imax was of 1721,7 ± 1455 (range 0–5313). In non malignant lesions, mean Imax was of 1691 ± 1143 (range 211–4835) in the targeted lesion, whereas it was of 2191,25 ±2022,4 (range 0–7538) in the collapsed perilesional lung, and of 890 ± 755 (range 174–1785) in the inflated perilesional lung, when available (Table 2 and Fig 3). Mean Imax of the perilesional lung was not statistically different whether it was associated with non-malignant lesion or a NSCLC (Fig 4).


Pulmonary Endogenous Fluorescence Allows the Distinction of Primary Lung Cancer from the Perilesional Lung Parenchyma.

Gust L, Toullec A, Benoit C, Farcy R, Garcia S, Secq V, Gaubert JY, Trousse D, Orsini B, Doddoli C, Moniz-Koum H, Thomas PA, D'journo XB - PLoS ONE (2015)

Difference of Mean Imax in absolute value of non-tumoural lesions and non small cell lung cancer with the associated perilesional lung parenchyma.Each dot was calculated with the mean Imax of the five measurements performed on the non-tumoural lesions (n = 24) and NSCLC (n = 60). The black bar corresponds to the median value of each subgroup. NSCLC: Non Small Cell Lung Cancer. NT: Non tumoural.
© Copyright Policy
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC4526534&req=5

pone.0134559.g003: Difference of Mean Imax in absolute value of non-tumoural lesions and non small cell lung cancer with the associated perilesional lung parenchyma.Each dot was calculated with the mean Imax of the five measurements performed on the non-tumoural lesions (n = 24) and NSCLC (n = 60). The black bar corresponds to the median value of each subgroup. NSCLC: Non Small Cell Lung Cancer. NT: Non tumoural.
Mentions: In ultimately proven NSCLC patients, mean Imax was of 4485 ± 2477 (range 45–17755) in the targeted lesion, whereas it was of 2228,27 ±1896 (range 45–10255) in the perilesional lung parenchyma. For the 32 samples for which inflation of perilesional lung was possible, mean Imax was of 1721,7 ± 1455 (range 0–5313). In non malignant lesions, mean Imax was of 1691 ± 1143 (range 211–4835) in the targeted lesion, whereas it was of 2191,25 ±2022,4 (range 0–7538) in the collapsed perilesional lung, and of 890 ± 755 (range 174–1785) in the inflated perilesional lung, when available (Table 2 and Fig 3). Mean Imax of the perilesional lung was not statistically different whether it was associated with non-malignant lesion or a NSCLC (Fig 4).

Bottom Line: Respective associated wavelengths were not statistically different between perilesional lung and either primary lung cancers or non-tumoral lesions.In contrast, photobleaching was significantly more frequently observed in the targeted lesions than in the perilesional lung (p≤0,01).Inconclusive results were found for lung metastases due to the heterogeneity of this population.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic Surgery and Diseases of the Oesophagus, North Hospital, Aix-Marseille University, Marseille, France.

ABSTRACT

Background: Pre-therapeutic pathological diagnosis is a crucial step of the management of pulmonary nodules suspected of being non small cell lung cancer (NSCLC), especially in the frame of currently implemented lung cancer screening programs in high-risk patients. Based on a human ex vivo model, we hypothesized that an embedded device measuring endogenous fluorescence would be able to distinguish pulmonary malignant lesions from the perilesional lung tissue.

Methods: Consecutive patients who underwent surgical resection of pulmonary lesions were included in this prospective and observational study over an 8-month period. Measurements were performed back table on surgical specimens in the operative room, both on suspicious lesions and the perilesional healthy parenchyma. Endogenous fluorescence signal was characterized according to three criteria: maximal intensity (Imax), wavelength, and shape of the signal (missing, stable, instable, photobleaching).

Results: Ninety-six patients with 111 suspicious lesions were included. Final pathological diagnoses were: primary lung cancers (n = 60), lung metastases of extra-thoracic malignancies (n = 27) and non-tumoral lesions (n = 24). Mean Imax was significantly higher in NSCLC targeted lesions when compared to the perilesional lung parenchyma (p<0,0001) or non-tumoral lesions (p<0,0001). Similarly, photobleaching was more frequently found in NSCLC than in perilesional lung (p<0,0001), or in non-tumoral lesions (p<0,001). Respective associated wavelengths were not statistically different between perilesional lung and either primary lung cancers or non-tumoral lesions. Considering lung metastases, both mean Imax and wavelength of the targeted lesions were not different from those of the perilesional lung tissue. In contrast, photobleaching was significantly more frequently observed in the targeted lesions than in the perilesional lung (p≤0,01).

Conclusion: Our results demonstrate that endogenous fluorescence applied to the diagnosis of lung nodules allows distinguishing NSCLC from the surrounding healthy parenchyma and from non-tumoral lesions. Inconclusive results were found for lung metastases due to the heterogeneity of this population.

No MeSH data available.


Related in: MedlinePlus