Stromal Targets for Fluorescent-Guided Oncologic Surgery.
Stromal Targets for Fluorescent-Guided Oncologic Surgery.
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DOI：
10.3389/fonc.2015.00254
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发表时间：
2015
影响因子：
4.7
通讯作者：
Sier CF
中科院分区：
文献类型：
--
作者：
Boonstra MC;Prakash J;Van De Velde CJ;Mesker WE;Kuppen PJ;Vahrmeijer AL;Sier CF
术前成像技术对于肿瘤检测和诊断至关重要，但在手术过程中提供的帮助有限。最近，使用与靶向抗体、肽或其他载体偶联的近红外荧光染料，成像在肿瘤手术期间的适用性已被认识到。图像引导肿瘤手术（IGOS）在手术过程中帮助外科医生区分肿瘤和正常组织，并有助于识别重要结构。IGOS依赖于专用荧光相机系统和用于靶向的特异性探针的优化组合。用于临床使用的IGOS探针尚未广泛使用，但已发表了许多临床前研究，并且正在建立或准备临床试验。大多数研究的探针是基于针对恶性细胞膜上的蛋白质的抗体或肽，而其他探针则针对基质细胞。IGOS靶向基质细胞有几个优点。除了在更具侵袭性的肿瘤类型中的高基质含量之外，基质通常主要位于肿瘤的外周/侵袭性前部，这使得基质靶特别适合于成像目的。此外，由于基质上调是一种生理反应，因此靶向这些细胞的大多数蛋白质是“通用的”，而不是来源于特定的遗传变异，就像恶性癌细胞上许多上调的蛋白质一样。
Pre-operative imaging techniques are essential for tumor detection and diagnosis, but offer limited help during surgery. Recently, the applicability of imaging during oncologic surgery has been recognized, using near-infrared fluorescent dyes conjugated to targeting antibodies, peptides, or other vehicles. Image-guided oncologic surgery (IGOS) assists the surgeFon to distinguish tumor from normal tissue during operation, and can aid in recognizing vital structures. IGOS relies on an optimized combination of a dedicated fluorescent camera system and specific probes for targeting. IGOS probes for clinical use are not widely available yet, but numerous pre-clinical studies have been published and clinical trials are being established or prepared. Most of the investigated probes are based on antibodies or peptides against proteins on the membranes of malignant cells, whereas others are directed against stromal cells. Targeting stroma cells for IGOS has several advantages. Besides the high stromal content in more aggressive tumor types, the stroma is often primarily located at the periphery/invasive front of the tumor, which makes stromal targets particularly suited for imaging purposes. Moreover, because stroma up-regulation is a physiological reaction, most proteins to be targeted on these cells are “universal” and not derived from a specific genetic variation, as is the case with many upregulated proteins on malignant cancer cells.