Rapid diagnosis and tumor margin assessment during pancreatic cancer surgery with the MasSpec Pen technology.

Autor:	King ME; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Zhang J; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Lin JQ; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Garza KY; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., DeHoog RJ; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Feider CL; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Bensussan A; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Sans M; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Krieger A; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Badal S; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Keating MF; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712., Woody S; Department of Integrative Biology, The University of Texas at Austin, Austin, TX 78712., Dhingra S; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030., Yu W; Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX 77030., Pirko C; Department of Surgery, Baylor College of Medicine, Houston, TX 77030., Brahmbhatt KA; Department of Surgery, Baylor College of Medicine, Houston, TX 77030., Van Buren G; Department of Surgery, Baylor College of Medicine, Houston, TX 77030., Fisher WE; Department of Surgery, Baylor College of Medicine, Houston, TX 77030., Suliburk J; Department of Surgery, Baylor College of Medicine, Houston, TX 77030 liviase@utexas.edu suliburk@bcm.edu., Eberlin LS; Department of Chemistry, The University of Texas at Austin, Austin, TX 78712; liviase@utexas.edu suliburk@bcm.edu.
Jazyk:	angličtina
Zdroj:	Proceedings of the National Academy of Sciences of the United States of America [Proc Natl Acad Sci U S A] 2021 Jul 13; Vol. 118 (28).
DOI:	10.1073/pnas.2104411118
Abstrakt:	Intraoperative delineation of tumor margins is critical for effective pancreatic cancer surgery. Yet, intraoperative frozen section analysis of tumor margins is a time-consuming and often challenging procedure that can yield confounding results due to histologic heterogeneity and tissue-processing artifacts. We have previously described the development of the MasSpec Pen technology as a handheld mass spectrometry-based device for nondestructive tissue analysis. Here, we evaluated the usefulness of the MasSpec Pen for intraoperative diagnosis of pancreatic ductal adenocarcinoma based on alterations in the metabolite and lipid profiles in in vivo and ex vivo tissues. We used the MasSpec Pen to analyze 157 banked human tissues, including pancreatic ductal adenocarcinoma, pancreatic, and bile duct tissues. Classification models generated from the molecular data yielded an overall agreement with pathology of 91.5%, sensitivity of 95.5%, and specificity of 89.7% for discriminating normal pancreas from cancer. We built a second classifier to distinguish bile duct from pancreatic cancer, achieving an overall accuracy of 95%, sensitivity of 92%, and specificity of 100%. We then translated the MasSpec Pen to the operative room and predicted on in vivo and ex vivo data acquired during 18 pancreatic surgeries, achieving 93.8% overall agreement with final postoperative pathology reports. Notably, when integrating banked tissue data with intraoperative data, an improved agreement of 100% was achieved. The result obtained demonstrate that the MasSpec Pen provides high predictive performance for tissue diagnosis and compatibility for intraoperative use, suggesting that the technology may be useful to guide surgical decision-making during pancreatic cancer surgeries. Competing Interests: Competing interest statement: M.E.K., J.Z., R.J.D., J.Q.L., C.L.F., J.S., and L.S.E. are inventors in US Patent 10,643,832 and/or in other patent applications related to the MasSpec Pen technology licensed by the University of Texas to MS Pen Technologies, Inc. J.Z., J.S., and L.S.E. are shareholders in MS Pen Technologies, Inc. J.S., L.S.E., and C.L.F. serve as chief medical officer, chief scientific officer, and a consultant, respectively, for MS Pen Technologies, Inc.
Databáze:	MEDLINE
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