Detecting tumour-positive resection margins after oral cancer surgery by spraying a fluorescent tracer activated by gamma-glutamyltranspeptidase.

Oral Oncology
Maxime D SlooterC W G M Löwik

Abstract

Tumour-positive resection margins are a major problem during oral cancer surgery. gGlu-HMRG is a tracer that becomes fluorescent upon activation by gamma-glutamyltranspeptidase (GGT). This study aims to investigate the combination of gGlu-HMRG and a clinical fluorescence imaging system for the detection of tumour-positive resection margins. The preclinical Maestro and clinical Artemis imaging systems were compared in vitro and ex vivo with cultured human head and neck cancer cells (OSC19, GGT-positive; and FaDu, GGT negative) and tumour-bearing nude mice. Subsequently, frozen sections of normal and oral cancer tissues were ex vivo sprayed with gGlu-HMRG to determine the sensitivity and specificity. Finally, resection margins of patients with suspected oral cancer were ex vivo sprayed with gGlu-HMRG to detect tumour-positive resection margins. Both systems could be used to detect gGlu-HMRG activation in vitro and ex vivo in GGT positive cancer cells. Sensitivity and specificity of gGlu-HMRG and the Artemis on frozen tissue samples was 80% and 87%, respectively. Seven patients undergoing surgery for suspected oral cancer were included. In three patients fluorescence was observed at the resection margin. Those margins were either ...Continue Reading

Citations

Jan 27, 2019·Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology·Yonggang ZhangLiang Du
Mar 8, 2019·Current Opinion in Otolaryngology & Head and Neck Surgery·Giuditta MannelliCesare Piazza
May 30, 2019·Frontiers in Pharmacology·Pieterjan Debie, Sophie Hernot
Jul 9, 2020·Scientific Reports·Paula Demétrio de Souza FrançaThomas Reiner
Dec 16, 2020·Proceedings of the National Academy of Sciences of the United States of America·Lingbo JinAshok Veeraraghavan
Mar 26, 2021·The Lancet Oncology·Lorraine J LauwerendsStijn Keereweer
Mar 25, 2021·Journal of Oral Pathology & Medicine : Official Publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology·Hye Min ChoNam-Pyo Cho
Apr 26, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·S G Brouwer de KoningM B Karakullukcu

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