A clinical trial of super-stable homogeneous lipiodol-nanoICG formulation-guided precise fluorescent laparoscopic hepatocellular carcinoma resection.
A clinical trial of super-stable homogeneous lipiodol-nanoICG formulation-guided precise fluorescent laparoscopic hepatocellular carcinoma resection.
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DOI：
10.1186/s12951-022-01467-w
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发表时间：
2022-06-03
影响因子：
10.2
通讯作者：
Liu, Gang
中科院分区：
文献类型：
--
作者：
He, Pan;Xiong, Yongfu;Ye, Jinfa;Chen, Biaoqi;Cheng, Hongwei;Liu, Hao;Zheng, Yating;Chu, Chengchao;Mao, Jingsong;Chen, Aizheng;Zhang, Yang;Li, Jingdong;Tian, Jie;Liu, Gang
关键词：
传统荧光导航技术在肝细胞癌中的应用受到假阳性率高、肿瘤分化程度不同、荧光性能不稳定等严重限制。本研究开发了一种绿色、经济、安全的纳米药物制剂技术，构建了无载体吲哚菁绿纳米颗粒（nanoICG），与ICG分子相比，其分子结构没有任何变化，尺寸均匀小，荧光性能更好。随后，通过超稳定均质混合制剂技术（SHIFT&nanoICG）将nanoICG分散到碘油中，用于肝动脉栓塞联合荧光腹腔镜肝切除术，消除了现有的缺点。 SHIFT&nanoICG 临床试验招募了一名 52 岁肝癌患者。我们证明SHIFT&nanoICG能够准确识别和标记病灶，具有优异的稳定性、栓塞性、光学成像性能以及较高的肿瘤与正常组织比，特别是在检测术前成像无法检测到的微卫星病灶（0.4 × 0.3 cm）方面，实现荧光腹腔镜下在更短的时间内（2 h内）、更少的术中完成肝细胞癌的完整切除失血量（50 毫升）。这种简单有效的策略将肝细胞癌的诊断和治疗融为一体，因此在各种临床应用中具有巨大的潜力。在线版本包含可在 10.1186/s12951-022-01467-w 获取的补充材料。
Applying traditional fluorescence navigation technologies in hepatocellular carcinoma is severely restricted by high false-positive rates, variable tumor differentiation, and unstable fluorescence performance. In this study, a green, economical and safe nanomedicine formulation technology was developed to construct carrier-free indocyanine green nanoparticles (nanoICG) with a small uniform size and better fluorescent properties without any molecular structure changes compared to the ICG molecule. Subsequently, nanoICG dispersed into lipiodol via a super-stable homogeneous intermixed formulation technology (SHIFT&nanoICG) for transhepatic arterial embolization combined with fluorescent laparoscopic hepatectomy to eliminate the existing shortcomings. A 52-year-old liver cancer patient was recruited for the clinical trial of SHIFT&nanoICG. We demonstrate that SHIFT&nanoICG could accurately identify and mark the lesion with excellent stability, embolism, optical imaging performance, and higher tumor-to-normal tissue ratio, especially in the detection of the microsatellite lesions (0.4 × 0.3 cm), which could not be detected by preoperative imaging, to realize a complete resection of hepatocellular carcinoma under fluorescence laparoscopy in a shorter period (within 2 h) and with less intraoperative blood loss (50 mL). This simple and effective strategy integrates the diagnosis and treatment of hepatocellular carcinoma, and thus, it has great potential in various clinical applications. The online version contains supplementary material available at 10.1186/s12951-022-01467-w.
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