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Fluorescence molecular imaging for identification of high-grade dysplasia in patients with head and neck cancer

Year: 2019
Type: article
Abstract: OBJECTIVE: High-grade dysplasia is associated with a risk of malignant transformation, and it is necessary to distinguish from normal epithelium or low-grade dysplasia, especially in the intraoperative setting. We hypothesize that an anti-epidermal growth factor receptor (EGFR) contrast agent can be used to differentiate high-grade dysplasia from low-grade dysplasia and normal epithelium. MATERIALS AND METHODS: Patients with biopsy proven head and neck squamous cell carcinoma (HNSCC) were enrolled in a clinical trial using systemically injected fluorescently labeled anti-EGFR antibody (panitumumab-IRDye800CW) (NCT02415881). Paraffin embedded tumor specimens from 11 patients were evaluated by fluorescence histopathology. Hematoxylin and eosin (H&E) slides were reviewed by a board-certified pathologist, and regions of invasive squamous cell carcinoma, high-grade dysplasia and low-grade dysplasia were delineated. EGFR expression was assessed for each patient by way of immunohistochemistry. RESULTS: 11 patients were included in the study with a total of 219 areas on tissue sections analyzed; 68 normal epithelium, 53 low-grade dysplasia, 48 high-grade dysplasia, and 50 malignant regions. The signal-to-background ratio (SBR) increased proportionally with increasing grade of dysplasia; normal epithelium (1.5 ± 0.1), low-grade dysplasia (1.8 ± 0.1), high-grade dysplasia: (2.3 ± 0.2). High-grade dysplasia had a significantly higher SBR when compared to normal or low-grade dysplasia (p < 0.05). Fluorescence histopathology positively correlated with EGFR expression by immunohistochemistry, which also increased proportionally with increasing degree of dysplasia. CONCLUSION: Molecular imaging with an anti-EGFR agent can successfully discriminate high-grade dysplastic lesions from low-grade dysplasia and normal epithelium.
DOI: 10.1016/j.oraloncology.2019.08.008
Authors: Shayan Fakurnejad, Stan van Keulen, Naoki Nishio, Myrthe Engelen, Nynke S. van den Berg, Guolan Lu, Andrew Birkeland, Fred Baik, A. Dimitrios Colevas, Eben L. Rosenthal, Brock A. Martin
Language: English
Field: Medicine
Open Access status: hybrid
Estimated APC paid: $2,750
Funders: Stanford University, Comprehensive Cancer Center, City of Hope, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, National Institutes of Health, School of Medicine, Stanford University, National Cancer Institute
OpenAlex ID: W2969027265
FWCI: 2.939
Cites: 23
Cited by: 24
Related to: 10