骨侵袭性口腔癌的手术切除边缘状态的术中定义是肿瘤手术中的一个根本性问题，因为缺乏快速骨分析方法。激光诱导击穿光谱（LIBS）提供了对最小组织样本的直接测量和实时检测。这个原理证明性研究旨在评估使用LIBS区分肿瘤和健康区域的可能性。LIBS实验执行于15名骨侵袭性口腔癌患者的原代颌骨切除标本上。比较了标准化和强度匹配的光谱。在生物衍生下，应用峰面积计算和主成分分析（PCA）。PCA的鉴别能力与激光治疗肿瘤组织的结构和细胞特征相关。使用接收器操作特征分析来评估LIBS在实时检测骨侵袭性癌症方面的性能。健康骨中钙（Ca）被钾（K）和钠（Na）替代。间质诱导的程度与健康和肿瘤光谱之间的鉴别能力显著相关。在本研究中，通过检测K和Na的胞内含量，LIBS实现了总体敏感性为95.51％，特异性为98.64％。本研究证明了LIBS在骨侵袭性口腔癌的实时检测方面的强大性能，这可能为建立LIBS作为快速骨分析方法奠定基础。进一步开发基于LIBS的骨肿瘤切除边缘评估可能会减少骨切除的范围，而不会损害肿瘤治疗的安全性。版权所有 © 2023 Elsevier Ltd.

Intraoperative definition of resection margin status in bone-invasive oral cancer is a fundamental problem in oncologic surgery due to the lack of rapid bone analysis methods. Laser-induced breakdown spectroscopy (LIBS) provides direct measurement with real-time examination of a minimal tissue sample. This proof-of-principle study aimed to evaluate the possibility of distinguishing tumorous and healthy areas with LIBS.LIBS experiments were executed on native segmental mandibulectomy specimens from 15 patients with bone-invasive oral cancer. Normalized and intensity-matched spectra were compared. Under biological derivation, peak area calculation and principal component analysis (PCA) were applied. The discriminatory power of the PCAs was correlated with the architectural and cytological characteristics of the lasered tumor tissue. Receiver operating characteristics analysis was used to evaluate the performance of LIBS in the real-time detection of bone-invasive cancer.Calcium (Ca), which is high in healthy bone, is replaced by potassium (K) and sodium (Na) in bone-invasive cancer. The degree of stromal induction is significantly correlated with the discriminatory power between healthy and tumorous spectra. In this study, LIBS ensured an overall sensitivity of 95.51% and a specificity of 98.64% via the intracellular detection of K and Na.This study demonstrated robust real-time detection of bone-invasive oral cancer with LIBS, which may lay the foundation for establishing LIBS as a rapid bone analysis method. Further development of a LIBS-guided assessment of bone tumor resection margins might reduce the extent of bony resection without compromising oncologic safety.Copyright © 2023 Elsevier Ltd. All rights reserved.