Changcheng Tao, Huiru Yang, Nan Hu, Bo Zheng, Zhiyu Lu, Weiqi Rong, Fan Wu, Liming Wang, Dayong Cao, Jianxiong Wu, Zhanhan Tu, Xuan Meng, Haizhen Lu, Hongguang Wang
{"title":"吲哚菁绿荧光成像引导下肝癌综合治疗的创新快速病理评估技术。","authors":"Changcheng Tao, Huiru Yang, Nan Hu, Bo Zheng, Zhiyu Lu, Weiqi Rong, Fan Wu, Liming Wang, Dayong Cao, Jianxiong Wu, Zhanhan Tu, Xuan Meng, Haizhen Lu, Hongguang Wang","doi":"10.1007/s13304-025-02301-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Traditional pathological techniques for diagnosing liver cancer are limited by the need for examination of multiple points. Preoperative treatment can complicate the evaluation by causing tumor necrosis. The evolving treatment landscape requires precise, integrated, and comprehensive management to address the limitations, specifically in localization, sampling, and speed. This study aims to innovatively explore the use of indocyanine green (ICG) fluorescence imaging to guide accurate and rapid localization of residual cancer foci, facilitating rapid pathological sampling and evaluation, termed as rapid pathological technology.</p><p><strong>Patients and methods: </strong>In this prospective and observational study, patients undergoing surgical resection for HCC were enrolled. Traditional evaluation involved specimen fixation, sampling, sectioning, and microscopic observation, while rapid evaluation entailed fluorescence-guided rapid pathological sampling and evaluation post-dissection.</p><p><strong>Results: </strong>A total of 37 HCC patients were included, and 103 samples of varying fluorescence intensity were collected. Analysis revealed a significant negative correlation between fluorescence intensity and tumor necrosis ratio (ρ = -0.89, p < 0.001). Furthermore, logistic regression modeling yielded an AUC of 0.947, with a specificity of 0.900 and sensitivity of 0.930, indicating strong discriminatory power for tumor necrosis status. An optimal cut-off fluorescence intensity of ≥ 20.5 was identified for predicting partial tumor necrosis. The Youden index is 0.830. Decision curve analysis demonstrated the clinical utility of the prediction model for guiding treatment decisions regarding tumor necrosis.</p><p><strong>Conclusions: </strong>Rapid pathological evaluation using ICG fluorescence-guided resection specimens in liver cancer is feasible, enabling effective localization of residual cancer foci and enhancing the accuracy and efficiency of pathological sampling.</p><p><strong>Trial registration: </strong>ChiCTR2400082814.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Innovative rapid pathological assessment technology for hepatocellular carcinoma following comprehensive treatment guided by indocyanine green fluorescence imaging.\",\"authors\":\"Changcheng Tao, Huiru Yang, Nan Hu, Bo Zheng, Zhiyu Lu, Weiqi Rong, Fan Wu, Liming Wang, Dayong Cao, Jianxiong Wu, Zhanhan Tu, Xuan Meng, Haizhen Lu, Hongguang Wang\",\"doi\":\"10.1007/s13304-025-02301-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Traditional pathological techniques for diagnosing liver cancer are limited by the need for examination of multiple points. Preoperative treatment can complicate the evaluation by causing tumor necrosis. The evolving treatment landscape requires precise, integrated, and comprehensive management to address the limitations, specifically in localization, sampling, and speed. This study aims to innovatively explore the use of indocyanine green (ICG) fluorescence imaging to guide accurate and rapid localization of residual cancer foci, facilitating rapid pathological sampling and evaluation, termed as rapid pathological technology.</p><p><strong>Patients and methods: </strong>In this prospective and observational study, patients undergoing surgical resection for HCC were enrolled. Traditional evaluation involved specimen fixation, sampling, sectioning, and microscopic observation, while rapid evaluation entailed fluorescence-guided rapid pathological sampling and evaluation post-dissection.</p><p><strong>Results: </strong>A total of 37 HCC patients were included, and 103 samples of varying fluorescence intensity were collected. Analysis revealed a significant negative correlation between fluorescence intensity and tumor necrosis ratio (ρ = -0.89, p < 0.001). Furthermore, logistic regression modeling yielded an AUC of 0.947, with a specificity of 0.900 and sensitivity of 0.930, indicating strong discriminatory power for tumor necrosis status. An optimal cut-off fluorescence intensity of ≥ 20.5 was identified for predicting partial tumor necrosis. The Youden index is 0.830. Decision curve analysis demonstrated the clinical utility of the prediction model for guiding treatment decisions regarding tumor necrosis.</p><p><strong>Conclusions: </strong>Rapid pathological evaluation using ICG fluorescence-guided resection specimens in liver cancer is feasible, enabling effective localization of residual cancer foci and enhancing the accuracy and efficiency of pathological sampling.</p><p><strong>Trial registration: </strong>ChiCTR2400082814.</p>\",\"PeriodicalId\":23391,\"journal\":{\"name\":\"Updates in Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-07-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Updates in Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s13304-025-02301-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Updates in Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13304-025-02301-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Innovative rapid pathological assessment technology for hepatocellular carcinoma following comprehensive treatment guided by indocyanine green fluorescence imaging.
Background: Traditional pathological techniques for diagnosing liver cancer are limited by the need for examination of multiple points. Preoperative treatment can complicate the evaluation by causing tumor necrosis. The evolving treatment landscape requires precise, integrated, and comprehensive management to address the limitations, specifically in localization, sampling, and speed. This study aims to innovatively explore the use of indocyanine green (ICG) fluorescence imaging to guide accurate and rapid localization of residual cancer foci, facilitating rapid pathological sampling and evaluation, termed as rapid pathological technology.
Patients and methods: In this prospective and observational study, patients undergoing surgical resection for HCC were enrolled. Traditional evaluation involved specimen fixation, sampling, sectioning, and microscopic observation, while rapid evaluation entailed fluorescence-guided rapid pathological sampling and evaluation post-dissection.
Results: A total of 37 HCC patients were included, and 103 samples of varying fluorescence intensity were collected. Analysis revealed a significant negative correlation between fluorescence intensity and tumor necrosis ratio (ρ = -0.89, p < 0.001). Furthermore, logistic regression modeling yielded an AUC of 0.947, with a specificity of 0.900 and sensitivity of 0.930, indicating strong discriminatory power for tumor necrosis status. An optimal cut-off fluorescence intensity of ≥ 20.5 was identified for predicting partial tumor necrosis. The Youden index is 0.830. Decision curve analysis demonstrated the clinical utility of the prediction model for guiding treatment decisions regarding tumor necrosis.
Conclusions: Rapid pathological evaluation using ICG fluorescence-guided resection specimens in liver cancer is feasible, enabling effective localization of residual cancer foci and enhancing the accuracy and efficiency of pathological sampling.
期刊介绍：
Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future.
Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts.
Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.
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