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首页> 美国卫生研究院文献>Cancers >Stratifying Brain Tumour Histological Sub-Types: The Application of ATR-FTIR Serum Spectroscopy in Secondary Care
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Stratifying Brain Tumour Histological Sub-Types: The Application of ATR-FTIR Serum Spectroscopy in Secondary Care

机译：分层脑肿瘤组织学子类型：ATR-FTIR血清光谱在二次护理中的应用

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Patients living with brain tumours have the highest average years of life lost of any cancer, ultimately reducing average life expectancy by 20 years. Diagnosis depends on brain imaging and most often confirmatory tissue biopsy for histology. The majority of patients experience non-specific symptoms, such as headache, and may be reviewed in primary care on multiple occasions before diagnosis is made. Sixty-two per cent of patients are diagnosed on brain imaging performed when they deteriorate and present to the emergency department. Histological diagnosis from invasive surgical biopsy is necessary prior to definitive treatment, because imaging techniques alone have difficulty in distinguishing between several types of brain cancer. However, surgery itself does not necessarily control tumour growth, and risks morbidity for the patient. Due to their similar features on brain scans, glioblastoma, primary central nervous system lymphoma and brain metastases have been known to cause radiological confusion. Non-invasive tests that support stratification of tumour subtype would enhance early personalisation of treatment selection and reduce the delay and risks associated with surgery for many patients. Techniques involving vibrational spectroscopy, such as attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy, have previously demonstrated analytical capabilities for cancer diagnostics. In this study, infrared spectra from 641 blood serum samples obtained from brain cancer and control patients have been collected. Firstly, we highlight the capability of ATR-FTIR to distinguish between healthy controls and brain cancer at sensitivities and specificities above 90%, before defining subtle differences in protein secondary structures between patient groups through Amide I deconvolution. We successfully differentiate several types of brain lesions (glioblastoma, meningioma, primary central nervous system lymphoma and metastasis) with balanced accuracies >80%. A reliable blood serum test capable of stratifying brain tumours in secondary care could potentially avoid surgery and speed up the time to definitive therapy, which would be of great value for both neurologists and patients.
机译：患有脑肿瘤的患者具有患有癌症的平均年龄最高，最终将平均预期寿命降低了20年。诊断取决于脑成像，最常见的是组织学的确认组织活检。大多数患者体验了非特异性症状，例如头痛，并且可以在诊断前多次在初级保健中进行审查。六十二分的患者被诊断出脑成像，当它们恶化和呈现给急诊部门时进行。在确定性治疗之前需要侵袭性手术活组织检查的组织学诊断，因为单独的成像技术难以区分几种类型的脑癌。然而，手术本身并不一定控制肿瘤生长，并为患者的发病率风险。由于它们对脑扫描的类似特征，已知胶质母细胞瘤，原发性中枢神经系统淋巴瘤和脑转移引起放射性混淆。支持肿瘤亚型分层的非侵入性试验将增强治疗选择的早期个性化，并降低许多患者的手术相关的延迟和风险。涉及振动光谱的技术，例如减弱的总反射傅里叶变换红外（ATR-FTIR）光谱，先前已经表现出癌症诊断的分析能力。在本研究中，收集了从脑癌和对照患者获得的641血清样品的红外光谱。首先，在90％以上的敏感性和特异性之前，突出ATR-FTIR在90％以上的特异性之间区分健康对照和脑癌的能力，然后通过酰胺I去卷积定义患者基团之间的蛋白质二次结构的微妙差异。我们成功地区分了几种类型的脑病变（胶质母细胞瘤，脑膜瘤，初级中枢神经系统淋巴瘤和转移），均衡精度> 80％。一种可靠的血清测试，能够在次级护理中分层脑肿瘤可能会避免手术，并加快最终治疗的时间，这对于神经根学家和患者来说都是很大的价值。

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