Molecular assessment of surgical-resection margins of gastric cancer by mass-spectrometric imaging

被引:167
作者
Eberlin, Livia S. [1 ]
Tibshirani, Robert J. [2 ,3 ]
Zhang, Jialing [1 ,4 ]
Longacre, Teri A. [5 ]
Berry, Gerald J. [5 ]
Bingham, David B. [5 ]
Norton, Jeffrey A. [6 ]
Zare, Richard N. [1 ]
Poultsides, George A. [6 ]
机构
[1] Stanford Univ, Dept Chem, Stanford, CA 94305 USA
[2] Stanford Univ, Dept Hlth Res & Policy, Stanford, CA 94305 USA
[3] Stanford Univ, Dept Stat, Stanford, CA 94305 USA
[4] Peking Univ, Dept Chem, Beijing 100871, Peoples R China
[5] Stanford Univ, Dept Pathol, Stanford, CA 94305 USA
[6] Stanford Univ, Dept Surg, Stanford, CA 94305 USA
基金
美国国家科学基金会; 美国国家卫生研究院;
关键词
mass spectrometry imaging; biostatistics; surgical margins; intraoperative diagnosis; ELECTROSPRAY-IONIZATION; FRAGMENTATION; PHOSPHATIDYLSERINE; QUADRUPOLE; SELECTION; SURVIVAL;
D O I
10.1073/pnas.1400274111
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Surgical resection is the main curative option for gastrointestinal cancers. The extent of cancer resection is commonly assessed during surgery by pathologic evaluation of (frozen sections of) the tissue at the resected specimen margin(s) to verify whether cancer is present. We compare this method to an alternative procedure, desorption electrospray ionization mass spectrometric imaging (DESI-MSI), for 62 banked human cancerous and normal gastric-tissue samples. In DESI-MSI, microdroplets strike the tissue sample, the resulting splash enters a mass spectrometer, and a statistical analysis, here, the Lasso method (which stands for least absolute shrinkage and selection operator and which is a multiclass logistic regression with L1 penalty), is applied to classify tissues based on the molecular information obtained directly from DESI-MSI. The methodology developed with 28 frozen training samples of clear histopathologic diagnosis showed an overall accuracy value of 98% for the 12,480 pixels evaluated in cross-validation (CV), and 97% when a completely independent set of samples was tested. By applying an additional spatial smoothing technique, the accuracy for both CV and the independent set of samples was 99% compared with histological diagnoses. To test our method for clinical use, we applied it to a total of 21 tissue-margin samples prospectively obtained from nine gastric-cancer patients. The results obtained suggest that DESI-MSI/Lasso may be valuable for routine intraoperative assessment of the specimen margins during gastric-cancer surgery.
引用
收藏
页码:2436 / 2441
页数:6
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