Clinical translation of ex vivo sentinel lymph node mapping for colorectal cancer using invisible near-infrared fluorescence light.
Clinical translation of ex vivo sentinel lymph node mapping for colorectal cancer using invisible near-infrared fluorescence light.
复制标题
DOI：
10.1245/s10434-010-1426-0
复制
发表时间：
2011-04
影响因子：
3.7
通讯作者：
Vahrmeijer AL
中科院分区：
文献类型：
--
作者：
Hutteman M;Choi HS;Mieog JS;van der Vorst JR;Ashitate Y;Kuppen PJ;van Groningen MC;Löwik CW;Smit VT;van de Velde CJ;Frangioni JV;Vahrmeijer AL
前哨淋巴结(SLN)标测在结直肠癌中可能具有预后和治疗意义；然而，目前可用的技术并不是最理想的。我们推测，不可见的近红外(NIR)荧光灯和体外注射的结合可以解决结直肠癌SLN标测的遗留问题。在猪的结肠和直肠内注射近红外淋巴示踪剂HSA800后，使用Flare成像系统实时识别SLN。在肿瘤切除后，使用相同的注射技术，在体内和体外共进行了32个SLN标测。在这些结果的指导下，对24例连续接受手术的结直肠癌患者的体外组织标本进行了SLN映射。使用近红外荧光可以实时跟踪从注射部位到SLN的淋巴流量。在猪中，在体内和体外条件下，32个SLN映射中有32个(100%)被识别出SLN。临床上，所有患者(n=24)均在注射荧光示踪剂后5分钟内采用体外策略确定了SLN。此外，9例患者有淋巴结转移(N1疾病)。在1例患者中，在肿瘤阴性的SLN附近发现了3毫米的肠系膜转移。目前的先导性研究证明，体外近红外荧光引导的SLN标测可以提供高灵敏度、快速和准确的结肠和直肠SLN识别。这创建了一个实验平台，用于在临床环境中测试优化的、非FDA批准的近红外荧光淋巴示踪剂。
Sentinel lymph node (SLN) mapping in colorectal cancer may have prognostic and therapeutic significance; however, currently available techniques are not optimal. We hypothesized that the combination of invisible near-infrared (NIR) fluorescent light and ex vivo injection could solve remaining problems of SLN mapping in colorectal cancer. The FLARE imaging system was used for real-time identification of SLNs after injection of the NIR lymphatic tracer HSA800 in the colon and rectum of (n = 4) pigs. A total of 32 SLN mappings were performed in vivo and ex vivo after oncologic resection using an identical injection technique. Guided by these results, SLN mappings were performed in ex vivo tissue specimens of 24 consecutive colorectal cancer patients undergoing resection. Lymph flow could be followed in real-time from the injection site to the SLN using NIR fluorescence. In pigs, the SLN was identified in 32 of 32 (100%) of SLN mappings under both in vivo and ex vivo conditions. Clinically, SLNs were identified in all patients (n = 24) using the ex vivo strategy within 5 min after injection of fluorescent tracer. Also, 9 patients showed lymph node involvement (N1 disease). In 1 patient, a 3-mm mesenteric metastasis was found adjacent to a tumor-negative SLN. The current pilot study shows proof of principle that ex vivo NIR fluorescence-guided SLN mapping can provide high-sensitivity, rapid, and accurate identification of SLNs in colon and rectum. This creates an experimental platform to test optimized, non-FDA-approved NIR fluorescent lymphatic tracers in a clinical setting.
登录
查看更多内容
影响因子：
9
作者：
Bertagnolli, M;Miedema, B;Compton, C
通讯作者：
Compton, C
影响因子：
9
作者：
Stojadinovic, Alexander;Nissan, Aviram;Peoples, George E.
通讯作者：
Peoples, George E.
影响因子：
45.3
作者：
Redston, M;Compton, CC;Bertagnolli, MM
通讯作者：
Bertagnolli, MM
影响因子：
9
作者：
Bembenek, Andreas E.;Rosenberg, Robert;Schlag, Peter M.
通讯作者：
Schlag, Peter M.
影响因子：
46.9
作者：
Kim, S;Lim, YT;Frangioni, JV
通讯作者：
Frangioni, JV