Intraoperative Evaluation of Breast Tissues During Breast Cancer Operations Using the MasSpec Pen.

Autor:	Garza KY; Department of Chemistry, The University of Texas at Austin., King ME; Department of Chemistry, The University of Texas at Austin.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Nagi C; Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas., DeHoog RJ; Department of Chemistry, The University of Texas at Austin.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Zhang J; Department of Chemistry, The University of Texas at Austin., Sans M; Department of Chemistry, The University of Texas at Austin., Krieger A; Department of Chemistry, The University of Texas at Austin., Feider CL; Department of Chemistry, The University of Texas at Austin., Bensussan AV; Department of Chemistry, The University of Texas at Austin., Keating MF; Department of Chemistry, The University of Texas at Austin.; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Lin JQ; Department of Chemistry, The University of Texas at Austin., Sun MW; Department of Biomedical Data Science, Stanford University, Stanford, California., Tibshirani R; Department of Biomedical Data Science, Stanford University, Stanford, California., Pirko C; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Brahmbhatt KA; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Al-Fartosi AR; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Thompson AM; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Bonefas E; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Suliburk J; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Carter SA; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas., Eberlin LS; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Jazyk:	angličtina
Zdroj:	JAMA network open [JAMA Netw Open] 2024 Mar 04; Vol. 7 (3), pp. e242684. Date of Electronic Publication: 2024 Mar 04.
DOI:	10.1001/jamanetworkopen.2024.2684
Abstrakt:	Importance: Surgery with complete tumor resection remains the main treatment option for patients with breast cancer. Yet, current technologies are limited in providing accurate assessment of breast tissue in vivo, warranting development of new technologies for surgical guidance. Objective: To evaluate the performance of the MasSpec Pen for accurate intraoperative assessment of breast tissues and surgical margins based on metabolic and lipid information. Design, Setting, and Participants: In this diagnostic study conducted between February 23, 2017, and August 19, 2021, the mass spectrometry-based device was used to analyze healthy breast and invasive ductal carcinoma (IDC) banked tissue samples from adult patients undergoing breast surgery for ductal carcinomas or nonmalignant conditions. Fresh-frozen tissue samples and touch imprints were analyzed in a laboratory. Intraoperative in vivo and ex vivo breast tissue analyses were performed by surgical staff in operating rooms (ORs) within 2 different hospitals at the Texas Medical Center. Molecular data were used to build statistical classifiers. Main Outcomes and Measures: Prediction results of tissue analyses from classification models were compared with gross assessment, frozen section analysis, and/or final postoperative pathology to assess accuracy. Results: All data acquired from the 143 banked tissue samples, including 79 healthy breast and 64 IDC tissues, were included in the statistical analysis. Data presented rich molecular profiles of healthy and IDC banked tissue samples, with significant changes in relative abundances observed for several metabolic species. Statistical classifiers yielded accuracies of 95.6%, 95.5%, and 90.6% for training, validation, and independent test sets, respectively. A total of 25 participants enrolled in the clinical, intraoperative study; all were female, and the median age was 58 years (IQR, 44-66 years). Intraoperative testing of the technology was successfully performed by surgical staff during 25 breast operations. Of 273 intraoperative analyses performed during 25 surgical cases, 147 analyses from 22 cases were subjected to statistical classification. Testing of the classifiers on 147 intraoperative mass spectra yielded 95.9% agreement with postoperative pathology results. Conclusions and Relevance: The findings of this diagnostic study suggest that the mass spectrometry-based system could be clinically valuable to surgeons and patients by enabling fast molecular-based intraoperative assessment of in vivo and ex vivo breast tissue samples and surgical margins.
Databáze:	MEDLINE
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