PMID- 26244637
OWN - NLM
STAT- MEDLINE
DCOM- 20160504
LR  - 20181113
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 10
IP  - 8
DP  - 2015
TI  - Pulmonary Endogenous Fluorescence Allows the Distinction of Primary Lung Cancer 
      from the Perilesional Lung Parenchyma.
PG  - e0134559
LID - 10.1371/journal.pone.0134559 [doi]
LID - e0134559
AB  - BACKGROUND: Pre-therapeutic pathological diagnosis is a crucial step of the 
      management of pulmonary nodules suspected of being non small cell lung cancer 
      (NSCLC), especially in the frame of currently implemented lung cancer screening 
      programs in high-risk patients. Based on a human ex vivo model, we hypothesized 
      that an embedded device measuring endogenous fluorescence would be able to 
      distinguish pulmonary malignant lesions from the perilesional lung tissue. 
      METHODS: Consecutive patients who underwent surgical resection of pulmonary 
      lesions were included in this prospective and observational study over an 8-month 
      period. Measurements were performed back table on surgical specimens in the 
      operative room, both on suspicious lesions and the perilesional healthy 
      parenchyma. Endogenous fluorescence signal was characterized according to three 
      criteria: maximal intensity (Imax), wavelength, and shape of the signal (missing, 
      stable, instable, photobleaching). RESULTS: Ninety-six patients with 111 
      suspicious lesions were included. Final pathological diagnoses were: primary lung 
      cancers (n = 60), lung metastases of extra-thoracic malignancies (n = 27) and 
      non-tumoral lesions (n = 24). Mean Imax was significantly higher in NSCLC 
      targeted lesions when compared to the perilesional lung parenchyma (p<0,0001) or 
      non-tumoral lesions (p<0,0001). Similarly, photobleaching was more frequently 
      found in NSCLC than in perilesional lung (p<0,0001), or in non-tumoral lesions 
      (p<0,001). Respective associated wavelengths were not statistically different 
      between perilesional lung and either primary lung cancers or non-tumoral lesions. 
      Considering lung metastases, both mean Imax and wavelength of the targeted 
      lesions were not different from those of the perilesional lung tissue. In 
      contrast, photobleaching was significantly more frequently observed in the 
      targeted lesions than in the perilesional lung (p</=0,01). CONCLUSION: Our results 
      demonstrate that endogenous fluorescence applied to the diagnosis of lung nodules 
      allows distinguishing NSCLC from the surrounding healthy parenchyma and from 
      non-tumoral lesions. Inconclusive results were found for lung metastases due to 
      the heterogeneity of this population.
FAU - Gust, Lucile
AU  - Gust L
AD  - Department of Thoracic Surgery and Diseases of the Oesophagus, North Hospital, 
      Aix-Marseille University, Marseille, France.
FAU - Toullec, Alexis
AU  - Toullec A
AD  - Nodea Medical, Villejuif, France.
FAU - Benoit, Charlotte
AU  - Benoit C
AD  - Nodea Medical, Villejuif, France.
FAU - Farcy, Rene
AU  - Farcy R
AD  - LAC, Paris-Sud XI University, Laboratoire Aime Cotton, Bat.505, Orsay, France.
FAU - Garcia, Stephane
AU  - Garcia S
AD  - Department of Pathology, North Hospital, Aix-Marseille University, Marseille, 
      France.
FAU - Secq, Veronique
AU  - Secq V
AD  - Department of Pathology, North Hospital, Aix-Marseille University, Marseille, 
      France.
FAU - Gaubert, Jean-Yves
AU  - Gaubert JY
AD  - Department of Radiology, Timone Hospital, Aix-Marseille University, Marseille, 
      France.
FAU - Trousse, Delphine
AU  - Trousse D
AD  - Department of Thoracic Surgery and Diseases of the Oesophagus, North Hospital, 
      Aix-Marseille University, Marseille, France.
FAU - Orsini, Bastien
AU  - Orsini B
AD  - Department of Thoracic Surgery and Diseases of the Oesophagus, North Hospital, 
      Aix-Marseille University, Marseille, France.
FAU - Doddoli, Christophe
AU  - Doddoli C
AD  - Department of Thoracic Surgery and Diseases of the Oesophagus, North Hospital, 
      Aix-Marseille University, Marseille, France.
FAU - Moniz-Koum, Helene
AU  - Moniz-Koum H
AD  - Nodea Medical, Villejuif, France.
FAU - Thomas, Pascal Alexandre
AU  - Thomas PA
AD  - Department of Thoracic Surgery and Diseases of the Oesophagus, North Hospital, 
      Aix-Marseille University, Marseille, France.
FAU - D'journo, Xavier Benoit
AU  - D'journo XB
AD  - Department of Thoracic Surgery and Diseases of the Oesophagus, North Hospital, 
      Aix-Marseille University, Marseille, France.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20150805
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Aged
MH  - Carcinoma, Non-Small-Cell Lung/*diagnosis/pathology
MH  - Early Detection of Cancer/*instrumentation
MH  - Female
MH  - Fluorescence
MH  - Humans
MH  - Lung/*pathology
MH  - Lung Neoplasms/*diagnosis/pathology
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
PMC - PMC4526534
COIS- Competing Interests: Alexis Toullec, Charlotte Benoit and Helene Moniz-Koum are 
      employees of the commercial funder of the study. NODEA MEDICAL is a start-up in 
      biotechnology born of the research in medical instrumentation, developing a new 
      method of cancer diagnosis measuring tissue fluorescence: PROBEA(R) 
      (patent degrees W02011010063). This does not alter the authors' adherence to PLOS ONE 
      policies on sharing data and materials.
EDAT- 2015/08/06 06:00
MHDA- 2016/05/05 06:00
PMCR- 2015/08/05
CRDT- 2015/08/06 06:00
PHST- 2014/10/29 00:00 [received]
PHST- 2015/07/11 00:00 [accepted]
PHST- 2015/08/06 06:00 [entrez]
PHST- 2015/08/06 06:00 [pubmed]
PHST- 2016/05/05 06:00 [medline]
PHST- 2015/08/05 00:00 [pmc-release]
AID - PONE-D-14-48687 [pii]
AID - 10.1371/journal.pone.0134559 [doi]
PST - epublish
SO  - PLoS One. 2015 Aug 5;10(8):e0134559. doi: 10.1371/journal.pone.0134559. 
      eCollection 2015.