Radioguided Detection of Lymph Node Metastasis in Non-Small Cell Lung Cancer

非小细胞肺癌淋巴结转移的放射引导检测

• 批准号: 7884284
• 负责人: CHUKWUMERE E. NWOGU
• 金额: $ 14.85万
• 依托单位: ROSWELL PARK CANCER INSTITUTE CORP
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7884284
• 关键词: Biological Assay; Biological Markers; Biological Markers; Cancer Etiology; Cancer Patient; Categories; Cessation of life; Clinical; Clinical Trials; Cyclin E; Detection; Diagnostic Neoplasm Staging; Enrollment; Gamma Rays; Goals; Hand; Hematoxylin and Eosin Staining Method; Histologic; Immunohistochemistry; Individual; Injection of therapeutic agent; Intravenous; Malignant Epithelial Cell; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Metastatic Carcinoma; Methods; Micrometastasis; Microscopic; Neoplasm Metastasis; Non-Small-Cell Lung Carcinoma; Pathologic; Patients; Positron; Positron-Emission Tomography; Primary Neoplasm; Quality of life; Radioactivity; Recurrence; Research Personnel; Research Project Grants; Resectable; Staging; Staining method; Stains; Stratification; Structure of lymph node of thorax; Techniques; Therapeutic; Tomogram; Tumor stage; United States; Vascular Endothelial Growth Factors; Woman; X-Ray Computed Tomography; career development; clinically relevant; cost; cyclin B1; design; fluorodeoxyglucose; improved; intravenous injection; lymph nodes; men; molecular marker; patient oriented; prognostic; programs; survivin; tumor

DESCRIPTION (provided by applicant): Lung cancer is the most frequent cause of cancer death in both men and women in the United States. Lymph node staging provides the most important prognostic information in patients with locoregional non-small cell lung cancer (NSCLC). Current methods of evaluating lymph nodes (hematoxylin-eosin staining) can miss micrometastases. Our first aim is to establish the utility of an intra-operative gamma probe to detect intravenously injected 18F-Fluorodeoxygulcose (FDG) in thoracic lymph nodes, thus improving the accuracy of lymph node staging in NSCLC. The potential ability of molecular markers to stratify patients with NSCLC into good and poor prognostic groups can alter therapeutic choices for individual patients. Thus, our second aim is to identify biological markers that may predict lymph node metastases (including micrometastases). We intend to achieve these goals by conducting a clinical trial involving 100 patients with resectable NSCLC. All the patients will have a pre-operative positron emission tomogram (PET). The PET-determined stage of the tumor will be compared with the stage determined by the use of an intra-operative gamma probe after intravenous FDG injection. The ability of the gamma probe to guide the detection of micrometastases will be assessed. Routine histologic staining of nodes will be compared to ultrastaging of the lymph node using intensive pathologic techniques. Assays of 4 biomarkers - cyclin B1, cyclin E, survivin and vascular endothelial growth factor (VEGF) - in the primary tumors will be done and correlated with lymph node metastases. This research project will be an integral part of a comprehensive career development program designed to prepare me as an independent patient-oriented investigator. This study is designed to detect microscopic spread of lung cancer to lymph nodes and to molecularly predict the aggressiveness of the cancer. This information will then facilitate therapeutic decisions.

描述（由申请人提供）：肺癌是美国男性和女性癌症死亡最常见的原因。淋巴结分期提供了局部非小细胞肺癌（NSCLC）患者中最重要的预后信息。当前评估淋巴结（苏木精 - 欧生染色）的方法可能会错过微转移酶。我们的第一个目的是建立术中伽马探头的实用性，以检测胸腔淋巴结中静脉注射的18F-氟脱氧氧化糖（FDG），从而提高了NSCLC中淋巴结的准确性。分子标记物将NSCLC患者分为良好和不良预后组的潜在能力可以改变单个患者的治疗选择。因此，我们的第二个目的是确定可以预测淋巴结转移（包括微转移）的生物标记物。我们打算通过进行涉及100例可切除NSCLC患者的临床试验来实现这些目标。所有患者将具有术前的正电子发射断层图（PET）。肿瘤的宠物确定的阶段将与静脉内FDG注射后使用术中γ探针确定的阶段进行比较。将评估γ探针指导检测微转移酶的能力。使用强化病理技术将节点的常规组织学染色与淋巴结的超压。将在原发性肿瘤中进行4种生物标志物 - 细胞周期蛋白B1，细胞周期蛋白E，Survivin和血管内皮生长因子（VEGF）的测定，并与淋巴结转移相关。该研究项目将是一项综合职业发展计划的组成部分，旨在为我作为一个独立的以患者为导向的研究者做好准备。这项研究旨在检测肺癌对淋巴结的微观传播，并可以预测癌症的侵略性。然后，此信息将促进治疗决定。