A Novel Method of Sentinel Lymph Node Mapping Using Magnetite in Patients with Thoracic Esophageal Cancer

胸食管癌患者使用磁铁矿进行前哨淋巴结定位的新方法

• 批准号: 14571174
• 负责人: OGAWA Jun-ichi
• 金额: $ 2.56万
• 依托单位: Akita University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2003
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14571174/
• 关键词: sentinel lymph node; thoracic esophageal cancer; magnetite; MRI; lymphatic mapping; magnetometer; Radioisotop; 食道癌; リンパ節転移; 磁気

The sentinel lymph node (SLN) concept has been applied to breast cancer and malignant melanoma for the purpose of minimizing-invasive surgery, but its applicability to thoracic esophageal cancer is unclear. The purpose of the present study is to evaluate SLN mapping in thoracic esophageal cancer patients using a new method that employs magnetite as a tracer. Before undergoing esophagectomy, ferumoxides (superparamagnetic iron oxides) was endoscopically injected into the submucosal layer of the peritumoral region in the thoracic esophagus. Thereafter, magnetic force from harvested lymph nodes was measured ex vivo using a highly sensitive, hand-held magnetometer. SLNs were mapped in all patients using our new method. Ferumoxides particles entrapped by macrophages were identified histopathologically in the lymph nodes, confirming their migration to SLNs. The number of SLNs averaged 9.3 in thoracic esophageal cancer and SLNs was widely distributed in the cervical, paratracheal, intrathoracic and perigastric regions. Our new method employing magnetite as a tracer for mapping SLNs is applicable to thoracic esophageal cancer. However, because the SLNs are distributed widely, the SLN concept may not be the basis of less-invasive surgery in thoracic esophageal cancer.

前哨淋巴结（SLN）的概念已被应用于乳腺癌和恶性黑色素瘤的微创手术的目的，但其适用于胸段食管癌还不清楚。本研究的目的是评估胸段食管癌患者的SLN标测使用一种新的方法，采用磁铁矿作为示踪剂。在进行食管切除术之前，通过内窥镜将ferumoxides（超顺磁性氧化铁）注射到胸段食管肿瘤周围区域的粘膜下层。此后，使用高灵敏度手持式磁力计离体测量来自收获的淋巴结的磁力。使用我们的新方法对所有患者的前哨淋巴结进行了定位。在淋巴结中的组织病理学检查中发现巨噬细胞截留的Ferumoxides颗粒，证实其迁移至SLN。胸段食管癌SLN平均为9.3枚，主要分布于颈段、胸壁、胸内及胃周。我们的新方法采用磁铁矿作为示踪剂映射SLN适用于胸段食管癌。然而，由于SLN分布广泛，SLN的概念可能不是胸段食管癌微创手术的基础。

项目成果

今野広志: "胸部食堂癌における磁性体を用いたMRI lymphatic mappingの検討"日本消化器外科学会雑誌. 35・7. 962 (2002)

Hiroshi Konno：“乳腺癌中使用磁性材料的 MRI 淋巴图谱研究”日本胃肠外科杂志 35・7（2002 年）。

Imano et al.: "A Novel Method of Sentinel Lymph Node Mapping Using Magnetite in Patients with Thoracic Esophageal Cancer"Akita J Med. 30. 91-98 (2003)

Imano 等人：“胸食管癌患者使用磁铁矿进行前哨淋巴结定位的新方法”Akita J Med。

Imano Hiroshi, et al.: "A Novel Method of Sentinel Lymph Node Mapping Using Magnetite in Patients with Thoracic Esophageal Cancer"Akita J Med.. 30. 91-98 (2002)

Imano Hiroshi 等人：“胸食管癌患者中使用磁铁矿进行前哨淋巴结定位的新方法”Akita J Med.. 30. 91-98 (2002)

今野広志: "A Novel Method of Sentinel Lymph Node Mapping Using Magnetite in patients with Thoracic Esophageal Cancer"秋田医学. (印刷中).

Hiroshi Konno：“胸食管癌患者使用磁铁矿进行前哨淋巴结定位的新方法”秋田医学科学（正在出版）。