Fluorescence as a concept in colorectal lymph node diagnosis.
Fluorescence detection may constitute an appropriate means in gastrointestinal cancers to diagnose lymphatic tumor spread as opposed to gamma-scintillation methods. Photodiagnostic tracers have been shown to localize rapidly in malignant cells and may enable sensitive detection of small cell aggregates in lymph nodes. To reach a detection depth of several millimeters, a broad banded unspecific tissue autofluorescence may be controlled by so-called background subtracting techniques, generally based either on fluorescence observation at several wavelengths or on dual-wavelength fluorescence excitation. Using such comparative fluorescence detection techniques, some tumor entities can be differentiated soley based upon autofluorescence characteristics. Introducing a further enhancement in sensitivity for longer life-time fluorophores by time delayed fluorescence detection we ran a pilot trial comprising 174 lymph nodes from colorectal cancer specimen from 9 patients. Metastatically involved lymph nodes could be differentiated from all other palpable nodes in the mesenteric fat at a specificity of 85% with a sensitivity of 65%. Specific fluorescence features may be useful to preselect tissue samples for further histological analysis.
Moesta
K T
KT
Robert-Roessle-Hospital, Charité, Humboldt Universität, Berlin, Germany.
Ebert
B
B
Handke
T
T
Rinneberg
H
H
Schlag
P M
PM
D000622:Aminolevulinic Acid / Q000008:administration & dosage; D015179:Colorectal Neoplasms / Q000473:pathology*; D017323:Dihematoporphyrin Ether; D005456:Fluorescent Dyes; D006418:Heme / Q000096:biosynthesis; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D010865:Pilot Projects; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013050:Spectrometry, Fluorescence / Q000295:instrumentation
D005456:Fluorescent Dyes; D006418:Heme; D000622:Aminolevulinic Acid; D017323:Dihematoporphyrin Ether