Fluorescence-guided surgery allows for more complete resection of pancreatic cancer, resulting in longer disease-free survival compared with standard surgery in orthotopic mouse models.
Fluorescence-guided surgery allows for more complete resection of pancreatic cancer, resulting in longer disease-free survival compared with standard surgery in orthotopic mouse models.
复制标题
DOI：
10.1016/j.jamcollsurg.2012.02.021
复制
发表时间：
2012-07
影响因子：
5.2
通讯作者：
Bouvet, Michael
中科院分区：
文献类型：
--
作者：
Metildi, Cristina A.;Kaushal, Sharmeela;Hardamon, Chanae R.;Snyder, Cynthia S.;Pu, Minya;Messer, Karen S.;Talamini, Mark A.;Hoffman, Robert M.;Bouvet, Michael
手术切缘阴性对于胰腺癌患者实现治愈和延长生存期至关重要。我们询问荧光引导手术（FGS）是否可以改善手术结果并降低人类胰腺癌原位小鼠模型的复发率。采用随机活性对照临床前试验，比较亮光手术（BLS）和荧光引导手术（FGS）。使用表达红色荧光蛋白（RFP）的BxPC-3胰腺癌细胞系建立人胰腺癌原位小鼠模型。原位植入后2周，用BLS或FGS切除肿瘤。使用OV-100小动物成像系统获得术前和术后图像，以评估手术切除的完整性。术后，进行全身成像以评估复发并跟踪肿瘤进展。术后6周，处死小鼠以评估原发性胰腺和转移性肿瘤负荷。与BLS相比，使用FGS实现了更完全的胰腺癌切除：98.9% vs. 77.1%，p=0.005。大多数接受BLS的小鼠（63.2%）有肉眼病变的证据，没有完全切除，而20%接受FGS的小鼠有完全切除，另外75%只有极轻微的残留病变（p=0.0001）。FGS组的平均术后肿瘤负荷显著低于BLS组：0.08 ± 0。06 mm 2与2.64 ± 0.63 mm 2，p=0.001。FGS组处死时的原发性肿瘤负荷显著低于BLS组：19.3 ± 5.3 mm 2 vs. 6.2 ± 3.6 mm 2，p=0.048。FGS的无病生存期显著长于BLS（p=0.02，HR=0.39，95% CI：（0.17，0.88））。使用荧光引导改善了胰腺癌的手术结局。这种新方法具有改善癌症手术治疗的巨大潜力。
Negative surgical margins are vital to achieve cure and prolong survival in patients with pancreatic cancer. We inquired if fluorescence-guided surgery (FGS) could improve surgical outcomes and reduce recurrence rates in orthotopic mouse models of human pancreatic cancer. A randomized active-control pre-clinical trial comparing bright light surgery (BLS) to fluorescence-guided surgery (FGS) was utilized. Orthotopic mouse models of human pancreatic cancer were established using the BxPC-3 pancreatic cancer cell line expressing red fluorescent protein (RFP). Two weeks after orthotopic implantation, tumors were resected with BLS or FGS. Pre- and postoperative images were obtained with the OV-100 Small Animal Imaging System to assess completeness of surgical resection. Postoperatively, whole body imaging was done to assess recurrence and follow tumor progression. Six weeks postoperatively, mice were sacrificed to evaluate primary pancreatic and metastatic tumor burden. A more complete resection of pancreatic cancer was achieved using FGS compared to BLS: 98.9% vs. 77.1%, p=0.005. The majority of mice undergoing BLS (63.2%) had evidence of gross disease with no complete resections, whereas 20% of mice undergoing FGS had complete resection and an additional 75% had only minimal residual disease (p=0.0001). The mean postoperative tumor burden was significantly less with FGS compared to BLS: 0.08 ± 0. 06 mm2 vs. 2.64 ± 0.63 mm2, p=0.001. The primary tumor burden at termination was significantly less with FGS compared to BLS: 19.3 ± 5.3 mm2 vs. 6.2 ± 3.6 mm2, p=0.048. FGS resulted in significantly longer disease-free survival than BLS (p=0.02, HR=0.39, 95% CI: (0.17, 0.88)). Surgical outcomes were improved in pancreatic cancer using fluorescence-guidance. This novel approach has significant potential to improve surgical treatment of cancer.
登录
查看更多内容
影响因子：
3.5
作者：
Kennedy, MD;Jallad, KN;Low, PS
通讯作者：
Low, PS
影响因子：
3.2
作者：
Kaushal, Sharmeela;McElroy, Michele K.;Luiken, George A.;Talamini, Mark A.;Moossa, A. R.;Hoffman, Robert M.;Bouvet, Michael
通讯作者：
Bouvet, Michael
DOI：
10.1196/annals.1414.024
发表时间：
2008-01-01
期刊：
RECENT ADVANCES IN CLINICAL ONCOLOGY
影响因子：
--
作者：
Loos, Martin;Kleeff, Joerg;Buechler, Markus W.
通讯作者：
Buechler, Markus W.
影响因子：
2.5
作者：
Sommerville, C. A. M.;Limongelli, P.;Jiao, L. R.
通讯作者：
Jiao, L. R.
影响因子：
2.6
作者：
Shimada, Kazuaki;Sakamoto, Yoshihiro;Hiraoka, Nobuyoshi
通讯作者：
Hiraoka, Nobuyoshi