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Lymphatic Mapping and Lymphatic Endothelial Cell Isolation in Colorectal Cancer Patients

结直肠癌患者的淋巴图谱和淋巴内皮细胞分离

基本信息

批准号：
16591298
负责人：
TAKEDA Akihiko
金额：
$ 2.18万
依托单位：
Saitama Medical School
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (C)
财政年份：
2004
资助国家：
日本
起止时间：
2004 至 2005
项目状态：
已结题

项目摘要

Background : SLN biopsy has already been established as a common procedure, and its clinical usefulness has been confirmed in patients with malignant lymphoma and breast cancer. In colorectal cancer, however, the application of the SLN theory remains uncommon and its clinical significance is also unclear. In addition, the characteristics of the lymphatic vessels that connect SLNs or the lymphatic endothelial cells have been unclear until now.Methods : SLN biopsy by the subserous dye injection method (patent blue) was conducted in 36 patients with colorectal cancer for which curative resection was possible (stage 0 : 2 cases, stage I : 18 cases, stage II : 4 cases, stage III : 12 cases), with additional systematic lymph node dissection. Endothelial cells were isolated from lymphatic vessels identified at the time of the SLN biopsy by the collagenase II perfusion method, and we tried to transfer them into a culture system with an endothelial cell-specific medium.Results : SLNs could be i … More dentified in 34 cases (94%). The total number of resected lymph nodes was 705, and 72 of those nodes were confirmed as SLNs (10.2%). Ten metastasis-positive nodes were found in SLNs (13.9%), and the mean number of identified SLNs per case was 2.0. The sensitivity to detect metastatic lymph nodes and the specificity of the SLN biopsy for all removed lymph nodes was 86.1% and 99.2%, respectively. No complications or toxicity associated with the dye injection were observed. In addition, cells isolated from removed lymphatic vessels formed colonies with endothelial cell-specific properties, and the expression of lymphatic endothelial cell-specific VEGFR-3 was observed.Conclusion : The SLN biopsy by the dye method for colorectal cancer is a procedure with high sensitivity, accuracy and safety that is applicable to cases with advanced cancer. In addition, a method was established to isolate only lymphatic endothelial cells from resected lymphatic vessels and to culture them. Our results are expected to be another milestone in the determination of the rational margin of resection in colorectal surgery and the future clarification of the mechanism of lymphatic metastasis. Less

背景资料：前哨淋巴结活检已被确立为一种常见的程序，其临床实用性已被证实在恶性淋巴瘤和乳腺癌患者。然而，在结直肠癌中，SLN理论的应用仍然不常见，其临床意义也不清楚。另外，SLN之间连接的淋巴管或淋巴管内皮细胞的特性至今仍不清楚。方法：采用浆膜下染料注射法对SLN进行活检对36例有可能根治性切除的结直肠癌患者进行了专利蓝染色（0期：2例，I期：18例，II期：4例，III期：12例），附加系统淋巴结清扫。通过胶原酶II灌注法从SLN活检时确定的淋巴管中分离内皮细胞，并尝试将其转移到含有内皮细胞特异性培养基的培养系统中。 ...更多信息确诊34例（94%）。共切除淋巴结705枚，其中前哨淋巴结72枚（10.2%）。在SLN中发现10个转移阳性淋巴结（13.9%），平均每例确定的SLN数为2.0。SLN活检对淋巴结转移的敏感性为86.1%，特异性为99.2%。未观察到与染料注射相关的并发症或毒性。此外，从切除的淋巴管中分离的细胞形成具有内皮细胞特异性的集落，并观察到淋巴管内皮细胞特异性的VEGFR-3的表达。结论：染料法活检结直肠癌前哨淋巴结是一种敏感性、准确性和安全性高的方法，适用于晚期癌症病例。此外，还建立了一种从切除的淋巴管中分离淋巴管内皮细胞并进行培养的方法。我们的研究结果有望成为结直肠手术合理切缘的确定和淋巴结转移机制的进一步阐明的又一里程碑。少