title: Multispectral imaging autofluorescence microscopy in colonic and gastric cancer metastatic lymph nodes.
abstract: OBJECTIVE
  The lymphadenectomy and extended lymphadenectomy procedures have been points of controversy in surgical oncology. The methods available for the detection of metastatic lymph nodes are numerous. These include lymphoscintigraphy and radiolabeled antibody detection, but in most cancers the currently used technique is sentinel lymph node identification, performed primarily through the use of immunohistochemistry. We propose the application of autofluorescence (AF)-based techniques for lymph node evaluation in colorectal and gastric tumors.
  
  
  METHODS
  We studied 30 clinical cases: 15 colorectal cancers and 15 gastric cancers. All of the patients were in the advanced stages of the disease and were candidates for adjuvant therapy. Autofluorescence microspectroscopy and multispectral imaging autofluorescence microscopy have been used to analyze the AF emission of metastatic lymph node sections, excited with 365-nm wavelength radiation. The AF spectra were recorded in the range of 400-700 nm. Monochrome AF images were acquired sequentially through interference filters peaked at 450, 550, and 650 nm, and then combined together in a single red-green-blue image. The AF pattern and the emission spectrum of metastatic lymph nodes have unique characteristics that can be used to distinguish them from the normal ones.
  
  
  RESULTS
  The results, compared with standard histopathologic procedures and with specific staining methods, supplied a satisfactory validation of the proposed technique, revealing the possibility of improving the actual diagnostic procedures for malignant lymph node alterations.
  
  
  CONCLUSIONS
  With the development of appropriate instrumentation, the proposed technique could be particularly suitable in intrasurgical diagnosis of metastatic lymph nodes.
authors.affiliation: Department of Critical Medicine and Surgery, University of Florence, Florence, Italy. dpantalone@unifi.it
authors.forename: Desiree
authors.initials: D
authors.lastname: Pantalone
authors.forename: Francesco
authors.initials: F
authors.lastname: Andreoli
authors.forename: Franco
authors.initials: F
authors.lastname: Fusi
authors.forename: Venere
authors.initials: V
authors.lastname: Basile
authors.forename: Giovanni
authors.initials: G
authors.lastname: Romano
authors.forename: GianMario
authors.initials: G
authors.lastname: Giustozzi
authors.forename: Luigi
authors.initials: L
authors.lastname: Rigacci
authors.forename: Renato
authors.initials: R
authors.lastname: Alterini
authors.forename: Monica
authors.initials: M
authors.lastname: Monici
mesh_terms: D003110:Colonic Neoplasms / Q000175:diagnosis*; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008856:Microscopy, Fluorescence; D013274:Stomach Neoplasms / Q000175:diagnosis*