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J Am Acad Dermatol. 2017 Feb;76(2):209-216.e9. doi: 10.1016/j.jaad.2016.09.008. Epub 2016 Nov 19.

Rapid visualization of nonmelanoma skin cancer.

Author information

1
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio.
2
Department of Dermatology, University Hospital, Cleveland, Ohio.
3
Department of Dermatology, Cleveland Clinic Foundation, Cleveland, Ohio.
4
Department of Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio.
5
Akrotome Imaging Inc, Cleveland, Ohio.
6
Department of Pathology, Stanford University, Stanford, California; Department of Microbiology and Immunology, Stanford University, Stanford, California.
7
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio; Department of Radiology, Case Western Reserve University, Cleveland, Ohio; National Foundation for Cancer Research Center for Molecular Imaging, Case Western Reserve University, Cleveland, Ohio. Electronic address: james.basilion@case.edu.

Abstract

BACKGROUND:

Mohs micrographic surgery examines all margins of the resected sample and has a 99% cure rate. However, many nonmelanoma skin cancers (NMSCs) are not readily amenable to Mohs micrographic surgery. This defines an unmet clinical need to assess the completeness of non-Mohs micrographic surgery resections during surgery to prevent re-excision/recurrence.

OBJECTIVE:

We sought to examine the utility of quenched activity-based probe imaging to discriminate cancerous versus normal-appearing skin tissue.

METHODS:

The quenched activity-based probe GB119 was applied to NMSC excised from 68 patients. We validated activation of the probe for hematoxylin-eosin-confirmed cancerous tissue versus normal-appearing skin tissue.

RESULTS:

Topical application of the probe differentiated basal cell carcinoma and squamous cell carcinoma from normal-appearing skin with overall estimated sensitivity and specificity of 0.989 (95% confidence interval 0.940-1.00) and 0.894 (95% confidence interval 0.769-0.965), respectively. Probe activation accurately defined peripheral margins of NMSC as compared with conventional hematoxylin-eosin-based pathology.

LIMITATIONS:

This study only examined NMSC debulking excision specimens. The sensitivity and specificity for this approach using final NMSC excision margins will be clinically important.

CONCLUSIONS:

These findings merit further studies to determine whether quenched activity-based probe technology may enable cost-effective increased cure rates for patients with NMSC by reducing re-excision and recurrence rates with a rapid and easily interpretable technological advance.

KEYWORDS:

cathepsin-B; cathepsin-L; molecular optical imaging; nonmelanoma skin cancer; quenched activity-based probe; re-excision rate; topical application

PMID:
27876303
PMCID:
PMC5341746
DOI:
10.1016/j.jaad.2016.09.008
[Indexed for MEDLINE]
Free PMC Article

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