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Subramonian S, Chopra S, Vidya R. New Alternative Techniques for Sentinel Lymph Node Biopsy. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2077. [PMID: 38138180 PMCID: PMC10744367 DOI: 10.3390/medicina59122077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 11/18/2023] [Accepted: 11/22/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: This review paper highlights the key alternatives to the blue dye/radioisotope method of sentinel lymph node biopsy (SLNB). It analyses the research available on these alternative methods and their outcomes compared to the traditional techniques. Materials and Methods: This review focused on fifteen articles, of which five used indocyanine green (ICG) as a tracer, four used magnetic tracers, one used one-step nucleic acid amplification (OSNA) and Metasin (quantitative reverse transcriptase-polymerase chain reaction), one used the photosensitiser talaporfin sodium, one used sulphur hexafluoride gas microbubbles, one used CT-guided lymphography and two focused on general SLNB technique reviews. Results: Of the 15 papers analysed, the sentinel node detection rates were 69-100% for indocyanine green, 91.67-100% for magnetic tracers, 81% for talaporfin sodium, 9.3-55.2% for sulphur hexafluoride gas microbubbles, 90.5% for CTLG and 82.7-100% for one-step nucleic acid amplification. Conclusions: Indocyanine green fluorescence (ICG) and magnetic tracers have been proven non-inferior to traditional blue dye and isotope regarding SLNB localisation. Further studies are needed to investigate the use of these techniques in conjunction with each other and the possible use of language learning models. Dedicated studies are required to assess cost efficacy and longer-term outcomes.
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Affiliation(s)
| | - Sharat Chopra
- Aneurin Bevan University Health Board, The Royal Gwent Hospital, Newport NP20 2UB, UK;
| | - Raghavan Vidya
- The Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK
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Pathania S, Khan MI, Bandyopadhyay S, Singh SS, Rani K, Parashar TR, Jayaram J, Mishra PR, Srivastava A, Mathur S, Hari S, Vanamail P, Hariprasad G. iTRAQ proteomics of sentinel lymph nodes for identification of extracellular matrix proteins to flag metastasis in early breast cancer. Sci Rep 2022; 12:8625. [PMID: 35599267 PMCID: PMC9124668 DOI: 10.1038/s41598-022-12352-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 05/03/2022] [Indexed: 12/24/2022] Open
Abstract
Patients with early breast cancer are affected by metastasis to axillary lymph nodes. Metastasis to these nodes is crucial for staging and quality of surgery. Sentinel Lymph Node Biopsy that is currently used to assess lymph node metastasis is not effective. This necessitates identification of biomarkers that can flag metastasis. Early stage breast cancer patients were recruited. Surgical resection of breast was followed by identification of sentinel lymph nodes. Fresh frozen section biopsy was used to assign metastatic and non-metastatic sentinel lymph nodes. Discovery phase included iTRAQ proteomics coupled with mass spectrometric analysis to identify differentially expressed proteins. Data is available via ProteomeXchange with identifier PXD027668. Validation was done by bioinformatic analysis and ELISA. There were 2398 unique protein groups and 109 differentially expressed proteins comparing metastatic and non-metastatic lymph nodes. Forty nine proteins were up-regulated, and sixty proteins that were down regulated in metastatic group. Bioinformatic analysis showed ECM-receptor interaction pathways to be implicated in lymph node metastasis. ELISA confirmed up-regulation of ECM proteins in metastatic lymph nodes. ECM proteins have requisite parameters to be developed as a diagnostic tool to assess status of sentinel lymph nodes to guide surgical intervention in early breast cancer.
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Sugiyama S, Iwai T, Baba J, Oguri S, Izumi T, Kuwahata A, Sekino M, Kusakabe M, Mitsudo K. Sentinel lymph node biopsy with a handheld cordless magnetic probe following preoperative MR lymphography using superparamagnetic iron oxide for clinically N0 early oral cancer: A feasibility study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:521-526. [PMID: 35007780 DOI: 10.1016/j.jormas.2022.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/02/2022] [Accepted: 01/05/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Radioisotope (RI) tracers are generally used for preoperative mapping of sentinel lymph node (SLN) and intraoperative detection with a portable γ probe. However, the use of RI has several limitations. Therefore, a method without RI is required for the widespread application of SLN biopsy. The purpose of this study was to evaluate the feasibility of SLN biopsy with a handheld cordless magnetic probe following magnetic resonance lymphography (MRL) using superparamagnetic iron oxide (SPIO) and for clinically N0 early oral cancer. MATERIALS AND METHODS MRL using SPIO and SLNB with the handheld cordless magnetic probe were performed for 27 patients with clinically N0 early oral cancer. RESULTS In all 27 patients (100%), SLNs were detected by MRL, and the total and mean number of SLNs were 73 and 2.7, respectively. All SLNs identified by MRL were detectable using the magnetic probe in all patients. CONCLUSIONS SLNB with handheld cordless magnetic probe following preoperative SLN mapping by MRL using SPIO is feasible, without RI use, for neck management in cases of clinically N0 early oral cancer.
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Affiliation(s)
- Satomi Sugiyama
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
| | - Junichi Baba
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Senri Oguri
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Toshiharu Izumi
- Department of Radiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
| | - Akihiro Kuwahata
- Department of Electrical Engineering, Tohoku University Graduate School of Engineering, Sendai, Miyagi 980-8579, Japan
| | - Masaki Sekino
- Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo, Tokyo 113-0032, Japan
| | - Moriaki Kusakabe
- Research Center for Food Safety, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo 113-0032, Japan; Department of Medical Device, Matrix Cell Research Institute Inc, Ushiku, Ibaraki 300-1232, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan
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Wan J, Oblak ML, Ram AS, McKenna C, Singh A, Nykamp S. Evaluating the Feasibility and Efficacy of a Dual-Modality Nanoparticle Contrast Agent (Nanotrast-CF800) for Image-Guided Sentinel Lymph Node Mapping in the Oral Cavity of Healthy Dogs. Front Vet Sci 2021; 8:721003. [PMID: 34631851 PMCID: PMC8494771 DOI: 10.3389/fvets.2021.721003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/27/2021] [Indexed: 01/08/2023] Open
Abstract
A combination of pre and intraoperative sentinel lymph node (SLN) mapping techniques have been suggested to optimize SLN detection. A novel liposomal nanoparticle, Nanotrast-CF800 (CF800), utilizes computed tomography lymphography (CTL) and near infrared fluorescence imaging (NIRF) for image-guided surgery and SLN mapping. This novel tracer agent has not been evaluated in companion animals. The objective of this study was to evaluate the feasibility and efficacy of CF800 for SLN mapping in the oral cavity of healthy dogs and to report any local adverse effects. Six healthy adult purpose-bred research dogs randomly received either 1 mL (group 1) or 2 mL (group 2) of CF800 injected into the submucosa at the level of the right canine maxillary tooth. CTL and percutaneous NIRF were performed at 1, 3, and 10 min, then 1, 2, 4, 7, and 10 days post-injection (p.i). Overall, both CTL and NIRF identified SLNs in all dogs. The overall peak mean contrast enhancement of the SLNs was 73.98 HU (range 63.45-86.27 HU) at 2 days p.i. Peak fluorescence of the SLN occurred at 1 day p.i. The agent was retained within the SLN for at least 7 days for CTL and 4 days for percutaneous NIRF. No adverse effects were observed. Local administration of CF800 was simple and feasible for the detection of SLNs using CTL+NIRF in the head and neck of healthy dogs and was not associated with significant local adverse events.
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Affiliation(s)
- Jennifer Wan
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Michelle L. Oblak
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Ann S. Ram
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Charly McKenna
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Stephanie Nykamp
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Sugiyama S, Iwai T, Baba J, Oguri S, Izumi T, Sekino M, Kusakabe M, Mitsudo K. MR lymphography with superparamagnetic iron oxide for sentinel lymph node mapping of N0 early oral cancer: A pilot study. Dentomaxillofac Radiol 2021; 50:20200333. [PMID: 33180632 DOI: 10.1259/dmfr.20200333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES The purpose of this pilot study was to evaluate the usefulness of magnetic resonance lymphography (MRL) with superparamagnetic iron oxide (SPIO) in sentinel lymph node (SLN) mapping of clinically N0 early oral cancer, and to conduct a comparative study of this MRL with CT lymphography (CTL). METHODS CTL and MRL were performed for SLN mapping before surgery for 20 patients with clinically N0 early oral cancer. The detection rate, number, and location of SLNs in CTL and MRL were evaluated. Furthermore, optimal scanning/imaging timing in MRL was examined. RESULTS SLNs were detected by CTL in 18 (90%) patients, and the total and mean number of SLN were 35 and 1.8, respectively. All SLNs could be detected 2 min and 3.5-5 min after contrast medium injection. In all patients, SLNs were detected by MRL at 10 min after SPIO injection, and the total and mean number of SLN was 53 and 2.7, respectively. MRL at 30 min after the injection showed additional 18 secondary lymph nodes. CONCLUSION MRL with SPIO is safe and useful imaging for the detection of SLNs in clinically N0 early oral cancer, and the optimal imaging timing is 10 min after SPIO injection.
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Affiliation(s)
- Satomi Sugiyama
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Junichi Baba
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Senri Oguri
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Toshiharu Izumi
- Department of Radiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Masaki Sekino
- Department of Electrical Engineering and Information Systems, Graduate School of Engineering, The University of Tokyo, Tokyo, Japan
| | - Moriaki Kusakabe
- Research Center for Food Safety, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan.,Department of Medical Device, Matrix Cell Research Institute Inc, Ushiku, Ibaraki, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
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Wan J, Oblak ML, Ram A, Singh A, Nykamp S. Determining agreement between preoperative computed tomography lymphography and indocyanine green near infrared fluorescence intraoperative imaging for sentinel lymph node mapping in dogs with oral tumours. Vet Comp Oncol 2021; 19:295-303. [PMID: 33403753 DOI: 10.1111/vco.12675] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/30/2020] [Accepted: 01/03/2021] [Indexed: 01/05/2023]
Abstract
Lymphatic drainage from the head and neck is variable with significant crossover, therefore sentinel lymph node (SLN) mapping can help ensure the appropriate lymph node(s) are sampled. To improve sensitivity, SLN mapping utilizing multiple modalities and a combination of preoperative computed tomography lymphography (CTL) and intraoperative near infrared fluorescence imaging (NIRF) with indocyanine green (ICG) +/- methylene blue (MB) dye has been suggested. The aim of this study was to describe a method for intraoperative ICG lymphography and determine agreement for SLN detection using preoperative CTL and intraoperative ICG NIRF + MB lymphography (IOL) in dogs with oral tumours. Fourteen client-owned dogs were included. All dogs had preoperative CTL with iodinated contrast and intraoperative IOL with an exoscope. Lymph nodes with CTL contrast-enhancement, blue staining or fluorescence were considered sentinel. The overall SLN identification rate was 100% when CTL and IOL were combined. A total of 57 SLNs were identified. Indocyanine green NIRF identified a greater proportion of SLNs (91%; 52/57) compared with MB (50.8%; 29/57) and CTL (42.1%; 24/57). Eighteen SLNs were identified by all three modalities with a fair level of agreement using Fleiss kappa. These findings suggest a combination of preoperative CTL with intraoperative SLN mapping techniques may greatly improve the ability to accurately detect the SLN in dogs with oral tumours.
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Affiliation(s)
- Jennifer Wan
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Michelle L Oblak
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Ann Ram
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Ameet Singh
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Stephanie Nykamp
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Cykowska A, Marano L, D'Ignazio A, Marrelli D, Swierblewski M, Jaskiewicz J, Roviello F, Polom K. New technologies in breast cancer sentinel lymph node biopsy; from the current gold standard to artificial intelligence. Surg Oncol 2020; 34:324-335. [PMID: 32791443 DOI: 10.1016/j.suronc.2020.06.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/28/2020] [Accepted: 06/18/2020] [Indexed: 01/14/2023]
Abstract
Sentinel lymph node biopsy is an important diagnostic procedure performed in early breast cancer patients with clinically negative axillary lymph nodes. Detection and examination of sentinel lymph nodes determine further therapy decisions, therefore a choice of optimal technique minimising the risk of false-negative results is of great importance. Currently, the gold standard is the dual technique comprising the blue dye and radiotracer, however, this method creates a logistical problem for many medical units. The intrinsic constraints of the existing methods led to the development of a very wide range of alternatives with varying clinical efficiency and feasibility. While each method presents with its own advantages and disadvantages, many techniques have improved enough to become a non-inferior alternative in the sentinel lymph node biopsy. Along with the improvement of the existing technologies, there are evolving trends such as multimodality of the techniques maximising the diagnostic outcome or an emerging use of artificial intelligence (AI) improving the workflow of the procedure. This literature review aims to give an overview of the current status of the standard techniques and emerging cutting-edge technologies in the sentinel lymph node biopsy.
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Affiliation(s)
- Anna Cykowska
- Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043, Italy.
| | - Luigi Marano
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Alessia D'Ignazio
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Daniele Marrelli
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Maciej Swierblewski
- Department of Surgical Oncology, Medical University of Gdansk, Gdańsk, 80-211, Poland
| | - Janusz Jaskiewicz
- Department of Surgical Oncology, Medical University of Gdansk, Gdańsk, 80-211, Poland
| | - Franco Roviello
- Department of Medicine, Surgery and Neurosciences, Unit of General Surgery and Surgical Oncology, University of Siena, Strada Delle Scotte, 4, 53100, Siena, Italy
| | - Karol Polom
- Department of Surgical Oncology, Medical University of Gdansk, Gdańsk, 80-211, Poland
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Head and neck robotic surgery combined with sentinel lymph node biopsy. Fascinating, but feasible? Oral Oncol 2020; 111:104939. [PMID: 32745899 DOI: 10.1016/j.oraloncology.2020.104939] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/08/2020] [Accepted: 07/27/2020] [Indexed: 02/05/2023]
Abstract
Robotic approaches and sentinel lymph node (SLN) biopsy are both strategies that evolved driven by the need to reduce impact of head and neck oncological surgery in terms of operative timing, morbidity, hospitalization time, and aesthetic results. A comprehensive review of the scientific literature was performed on PubMed, Embase, ResearchGate, Cochrane, and CENTRAL electronic databases with the aim to discuss the role that these two approaches can play together in the management of head and neck cancers (HNCs) of various sites. Dedicated publications on the combined robotics and SLN biopsy approaches resulted, up to now very limited, while their separated application in non-shared fields is gaining strength. However, the possibility to implement and combine technologies to minimize sequelae of head and neck surgery is an interesting and evolving topic.
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Pathania S, Khan MI, Kumar A, Gupta AK, Rani K, Ramesh Parashar T, Jayaram J, Ranjan Mishra P, Srivastava A, Mathur S, Hari S, Hariprasad G. Proteomics of Sentinel Lymph Nodes in Early Breast Cancer for Identification of Thymidylate Synthase as a Potential Biomarker to Flag Metastasis: A Preliminary Study. Cancer Manag Res 2020; 12:4841-4854. [PMID: 32606973 PMCID: PMC7320752 DOI: 10.2147/cmar.s255684] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/21/2020] [Indexed: 12/30/2022] Open
Abstract
Introduction Breast cancer is the second most common cancer in women across the world. Some of the patients who present in the early stage of disease are affected by metastasis to the axillary group of lymph nodes. The first among this group that is affected is called as sentinel lymph node, and its diagnosis is crucial for the staging of cancer thereby dictating the type of surgical therapy. Therefore, the sentinel lymph node status provides the most relevant information to the surgeon and patient prognosis. The expanded utilization of breast conservation surgery has declined the morbidity associated with mastectomy and axillary lymph node surgery. Recent interest is, therefore, centered on techniques that allow accurate assessment of the sentinel lymph node metastasis. A current procedure such as sentinel lymph node biopsy (SLNB) that is used to assess axillary lymph node metastasis is neither specific nor sensitive, and besides, it is time-consuming. Objective To compare the protein profiles between metastatic and non-metastatic lymph nodes to identify a biomarker that can flag lymph node metastasis. Materials and Methods Women with early breast cancer were screened using mammography imaging and recruited to the study. Surgical resection was done to remove the breast tissue, and sentinel lymph node was identified using fluorescein and methylene blue tracer. Lymph node was sliced, and one set was sent for histopathology, which was considered the gold standard to assess the metastatic status of the lymph node. One set of slices was taken for proteomic experiments. Proteins were labelled with fluorescent cyanine tags and were subjected to difference gel electrophoresis experiment. Differentially expressed spots that had at least a twofold relative ratio and consistent pattern across three sets of biological replicate experiments were marked. Gel spots were trypsin digested and identified on mass spectrometry machine. Validation study was done by Western blot experiment on the same set of samples. Results Thymidylate synthase has a twofold higher expression in the metastatic sentinel lymph nodes as compared to non-metastatic lymph nodes in early breast cancer patients. Conclusion Differential in gel expression proteomics is an ideal platform for the identification of potential protein biomarker candidates that can differentiate metastatic from non-metastatic lymph nodes in early breast cancer. The identification of thymidylate synthase offers a scope to develop an on-table diagnostic kit to assess the status of sentinel lymph nodes during mastectomy procedure to guide surgical management of axillary lymph nodes in early breast cancer. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/cwaN4SoFgZk
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Affiliation(s)
- Sheetal Pathania
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Mohd Imran Khan
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Abhishek Kumar
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ashish Kumar Gupta
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Komal Rani
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Tanvi Ramesh Parashar
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Jnaneshwari Jayaram
- Department of Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Piyush Ranjan Mishra
- Department of Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Anurag Srivastava
- Department of Surgery, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Sandeep Mathur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Smriti Hari
- Department of Radiology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Gururao Hariprasad
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India
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Sugiyama S, Iwai T, Izumi T, Baba J, Oguri S, Hirota M, Mitsudo K. Sentinel lymph node mapping of clinically N0 early oral cancer: a diagnostic pitfall on CT lymphography. Oral Radiol 2020; 37:251-255. [PMID: 32419102 DOI: 10.1007/s11282-020-00442-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 05/03/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The purpose of this study was to reevaluate preoperative computed tomography lymphography (CTL) and enhanced CT images during follow-up to clarify whether SLNs enhanced by CTL were identified accurately before primary surgery with sentinel lymph node biopsy (SLNB) for clinically N0 early oral cancer. METHODS Thirty two early oral cancer patients without cervical lymph node metastasis were enrolled in this study. To clarify whether SLNs enhanced by CTL were identified accurately before primary surgery with SLNB, we reevaluated preoperative CTL and enhanced CT images during follow-up in all patients. RESULTS SLNs were detected by CTL in 31 of 32 patients (96.9%). During follow-up after primary surgery with SLNB, 4 of 27 patients without SLN metastasis had occult neck metastasis. Of the 4 patients, only 1 patient with cancer of floor of the mouth had overlooking of SLN, and the overlooking rate of SLN was 3.1%. The overlooked small SLN (2.9 × 3.3 × 3.1 mm) was located at contralateral level IB. The CT numbers before, 2, 5, 10 min after iopamidol injection, were 33 HU, 37 HU, 62 HU, 52 HU, respectively. The CT numbers of overlooked SLN 5 and 10 min after the injection was higher than CT images scanned before the iopamidol injection. CONCLUSIONS The enhancement of SLNs in CTL images after iopamidol injection should be compared sufficiently with CT images before iopamidol injection to avoid overlooking of SLNs in N0 early oral cancer.
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Affiliation(s)
- Satomi Sugiyama
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Toshiharu Izumi
- Department of Radiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Junichi Baba
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Senri Oguri
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Makoto Hirota
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Medical Center, 4-57 Urafunecho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Ishiguro K, Iwai T, Izumi T, Sugiyama S, Baba J, Oguri S, Hirota M, Mitsudo K. Sentinel lymph node biopsy with preoperative CT lymphography and intraoperative indocyanine green fluorescence imaging for N0 early tongue cancer: A long-term follow-up study. J Craniomaxillofac Surg 2020; 48:217-222. [DOI: 10.1016/j.jcms.2020.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/22/2019] [Accepted: 01/18/2020] [Indexed: 12/20/2022] Open
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Sugiyama S, Iwai T, Izumi T, Ishiguro K, Baba J, Oguri S, Mitsudo K. CT lymphography for sentinel lymph node mapping of clinically N0 early oral cancer. Cancer Imaging 2019; 19:72. [PMID: 31718717 PMCID: PMC6852886 DOI: 10.1186/s40644-019-0258-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/30/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The objectives of this retrospective study were to evaluate the usefulness of computed tomography lymphography (CTL) and to clarify the optimal timing of CTL in sentinel lymph node (SLN) mapping of clinically N0 early oral cancer. METHODS Twenty patients with clinically N0 early oral cancer underwent CTL with a 128 multi-detector row CT scanner to detect SLN the day before resection of primary tumor and SLN biopsy with indocyanine green (ICG) fluorescence guidance. CT scanning was performed in the first 10 patients at 2, 5, and 10 min after submucosal injection of iopamidol and in the remaining 10 patients at 2, 3.5, 5, and 10 min after the injection of contrast medium. We evaluated the SLN detection rate at each scan timing and the number and location of SLNs. We evaluated whether CTL-enhanced SLNs could be identified intraoperatively as ICG fluorescent lymph nodes. RESULTS SLNs were detected by CTL in 19 of the 20 patients (95.0%), and the mean number of SLNs was 2 (range, 1-4). All SLNs were located on the ipsilateral side; 35 of 37 SLNs were located at level I and II, and 2 SLNs were lingual lymph nodes. All SLNs could be detected 2 min and 3.5-5 min after contrast medium injection, and CTL-enhanced SLNs could be identified intraoperatively as fluorescent lymph nodes. CONCLUSIONS CTL could facilitate the detection of SLNs in early oral cancer, and the optimal timing of CT scanning was at 2 and 5 min after injection of contrast medium.
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Affiliation(s)
- Satomi Sugiyama
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Toshinori Iwai
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Toshiharu Izumi
- Department of Radiology, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Keita Ishiguro
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Junichi Baba
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Senri Oguri
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery/Orthodontics, Yokohama City University hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
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Hamdy O, El-Badrawy A, Saleh GA, Metwally IH, Abdelwahab K, Farouk O, Denewer A, Setit A. Preoperative localization of sentinel lymph node in breast cancer patients by silver wire insertion or liquid charcoal injection guided by CT lymphography. Breast J 2019; 26:617-624. [PMID: 31448502 DOI: 10.1111/tbj.13511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/14/2019] [Accepted: 07/16/2019] [Indexed: 12/23/2022]
Abstract
Dual localization of SLN in breast cancer patients using isotope & dye is the best-approved modality with limitations such as high cost of radioactive materials, complex logistic preparations & scheduling issues, especially in developing countries. We investigated the feasibility & accuracy of a novel technique for SLN localization using silver wire insertion or liquid charcoal injection guided by CT lymphography. 120 patients with clinically node-negative breast cancer were enrolled. In the test group, SLN was localized using preoperative CTLG guided injection of liquid charcoal or by placing a 3 cm silver wire. In addition, intraoperative SLN mapping was performed using methylene blue dye followed by searching for the SLN localized by both methods. In the control group, SLN was localized by the blue dye only. Feasibility, accuracy, detection rates, and number of SLNs retrieved were reported as well as matching between the LN detected with the CTLG and that detected with the dye technique. SLN could be detected in 59 out of 60 patients (98.3%) in the test group and in 54 out of 60 patients (90%) in the control group (P = .057). In self-controlled analysis of the test group comparing CTLG only to dye only was significant (P = .050). Comparing charcoal to silver wire in detection was statistically insignificant (P = .5). This novel method can offer advantages which are as follows: being more accurate than the dye alone, saving operative time, abandoning complex logistic preparations for the radioisotope, and solving the problem of timing.
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Affiliation(s)
- Omar Hamdy
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Adel El-Badrawy
- Radiology Department, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Gehad A Saleh
- Radiology Department, Faculty of medicine, Mansoura University, Mansoura, Egypt
| | - Islam H Metwally
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Khaled Abdelwahab
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Omar Farouk
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Adel Denewer
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
| | - Ahmed Setit
- Surgical Oncology Unit, Oncology Center, Mansoura University, Mansoura, Egypt
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Yang Y, Zhou B, Zhou J, Shi X, Sha Y, Wu H. Assessment of lingual sentinel lymph nodes metastases using dual-modal indirect CT/MR lymphography with gold-gadolinium-based nanoprobes in a tongue VX 2 carcinoma model. Acta Otolaryngol 2018. [PMID: 29513120 DOI: 10.1080/00016489.2018.1441544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To evaluate the capability of indirect computed tomography and magnetic resonance lymphography (CT/MR-LG) with gadolinium-loaded, polyethylenimine-entrapped gold nanoprobes (Gd-Au PENPs) for assessing lingual sentinel lymph node (SLN) metastasis in a tongue VX2 carcinoma model. MATERIALS AND METHODS Seventeen rabbits were used to establish a metastatic cervical lymph node model by implanting VX2 carcinoma suspension into the ventral tongue muscle. CT and MR images were acquired one hour after Gd-Au PENPs injection into the tongue submucosa bilaterally, on 1w (n = 4), 2w (n = 6) and 3w (n = 7) tumour-bearing rabbits after carcinoma transplantation. Then, the filling defects and enhancement features of the lingual SLN on indirect CT/MR-LG were assessed. RESULTS The enhanced lingual SLNs were observed bilaterally in all rabbits using indirect CT/MR-LG. In total, 15 enhanced SLNs displayed oval or round shape with uniform density and no filling defects or only local small filling defects, and all nodes were metastasis-negative, while 19 enhanced SLNs demonstrated irregular morphologies with filling defects, non-uniform densities and unclear borders, of which 14 nodes were metastatic. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value when using SLN enhancement with irregular morphology, filling defects, non-uniform density and unclear border as diagnostic criteria for metastasis were 100%, 75.0%, 85.3%, 73.7% and 100%, respectively. CONCLUSIONS Indirect CT/MR-LG with Gd-Au PENPs can be used for the metastatic diagnosis of lingual SLN in tongue cancer.
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Affiliation(s)
- Yue Yang
- Departments of Otolaryngology-Head and Neck Surgery, Fudan University, Shanghai, China
- Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Benqing Zhou
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Jian Zhou
- Departments of Otolaryngology-Head and Neck Surgery, Fudan University, Shanghai, China
- Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Xiangyang Shi
- College of Chemistry, Chemical Engineering and Biotechnology, Donghua University, Shanghai, China
| | - Yan Sha
- Departments of Radiology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Haitao Wu
- Departments of Otolaryngology-Head and Neck Surgery, Fudan University, Shanghai, China
- Shanghai Key Clinical Disciplines of otorhinolaryngology, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, China
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15
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Shi F, Liang Z, Zhang Q, Wang C, Liu X. The performance of one-step nucleic acid amplification assay for intraoperative detection of sentinel lymph node macrometastasis in breast cancer: An updated meta-analysis. Breast 2018; 39:39-45. [PMID: 29574393 DOI: 10.1016/j.breast.2018.03.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 03/14/2018] [Accepted: 03/15/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND One-step nucleic acid amplification (OSNA) assay is a molecular diagnostic method for intraoperative detection of lymph node metastasis by amplifying cytokeratin 19 mRNA. We aim to further evaluate the performance of OSNA assay for the intraoperative diagnosis of sentinel lymph node metastasis in breast cancer. METHODS PubMed, Cochrane Library, Web of Science databases were searched to retrieve related literature published up until December 2017. This meta-analysis was performed using a random-effects model. Risks of bias and quality assessments of included studies were evaluated and subgroup analysis was performed. RESULTS Nineteen studies were included in this meta-analysis. For overall metastasis, the pooled sensitivity, specificity and area under the summary receiver-operating characteristic curve (AUC) were 0.90, 0.96 and 0.98, respectively. For macrometastasis, the pooled sensitivity, specificity and AUC were 0.85, 0.98 and 0.94, respectively. CONCLUSION OSNA assay is an accurate molecular diagnosis for intraoperative detection of sentinel lymph node macrometastasis in breast cancer.
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Affiliation(s)
- Fang Shi
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Zhenzhen Liang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Qian Zhang
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun 130021, China.
| | - Chunpeng Wang
- School of Mathematics and Statistics, Northeast Normal University, Changchun, Jilin, China.
| | - Xin Liu
- Department of Epidemiology and Statistics, School of Public Health, Jilin University, Changchun 130021, China.
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16
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Beer P, Pozzi A, Rohrer Bley C, Bacon N, Pfammatter NS, Venzin C. The role of sentinel lymph node mapping in small animal veterinary medicine: A comparison with current approaches in human medicine. Vet Comp Oncol 2017; 16:178-187. [DOI: 10.1111/vco.12372] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 10/17/2017] [Indexed: 12/20/2022]
Affiliation(s)
- P. Beer
- Clinic for Small Animal Surgery, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - A. Pozzi
- Clinic for Small Animal Surgery, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - C. Rohrer Bley
- Division of Radiation Oncology, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - N. Bacon
- Fitzpatrick Referrals Oncology and Soft Tissue; Guildford Hospital; Guildford UK
| | - N. S. Pfammatter
- Clinic for Diagnostic Imaging, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
| | - C. Venzin
- Clinic for Small Animal Surgery, Vetsuisse Faculty; University of Zurich; Zurich Switzerland
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One-step nucleic acid amplification assay is an accurate technique for sentinel lymph node biopsy of breast cancer patients: a meta-analysis. Br J Cancer 2017; 117:1185-1191. [PMID: 28797030 PMCID: PMC5674095 DOI: 10.1038/bjc.2017.262] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/01/2017] [Accepted: 07/13/2017] [Indexed: 11/11/2022] Open
Abstract
Background: To estimate the accuracy of one-step nucleic acid amplification (OSNA) assay as an intra-operative sentinel lymph node biopsy (SLNB) for sentinel lymph node (SLN) metastasis in breast cancer. Methods: PubMed, Cochrane Library and Web of Science databases were searched by two independent reviewers to retrieve literature with per-patient analysis. The deadline was up until December 2016. A meta-analysis was performed using STATA, Meta-Disc, and Revman software. A random-effects model was used and subgroup analysis was carried out to identify possible sources of heterogeneity. Results: According to the inclusion criteria, 2833 patients from 12 studies were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and the area under the sROC curve (AUC) for detecting SLN metastasis were 0.87 (95% CI 0.81–0.91), 0.92 (95% CI 0.86–0.95), 10.65 (95% CI 6.18–18.34), 0.14 (95% CI 0.10–0.20), 75.08 (95% CI 37.77–149.22) and 0.94 (95% CI 0.91–0.95), respectively. Conclusions: The present study adds the evidence that OSNA assay is an accurate molecular diagnostic tool for intra-operatively detecting SLN metastasis in breast cancer. One-step nucleic acid amplification assay might be introduced into clinical usage for replacing traditional intro-operative diagnostic methods of SLNB.
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Yang Y, Shi F, Zhou J, Shi X, Sha Y, Wu H. Short-Term Dynamic Observation of the Color Change and Enhancement Effect of Polyethylenimine-Entrapped Gold Nanoparticles Used for Indirect Lymphography. ORL J Otorhinolaryngol Relat Spec 2016; 78:136-43. [PMID: 27234613 DOI: 10.1159/000446190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/12/2016] [Indexed: 11/19/2022]
Abstract
AIMS To dynamically observe the color change and enhancement effect of gadolinium-loaded polyethylenimine-entrapped gold nanoparticles (Gd-Au PENPs) as a dual-mode CT/MRI contrast agent for sentinel lymph node (SLN) identification. METHODS In 6 rabbits, Gd-Au PENPs were injected into the right side tongue submucosa, after which the color change of cervical draining lymph nodes was observed. Then the draining lymph nodes were examined by CT/MRI scan. Another 6 rabbits were randomly divided into a CT lymphography (CT-LG) and a MRI lymphography (MRI-LG) group and examined by CT/MRI scan 1 and 30 min after injection. Then SLNs were identified under the guidance of CT/MRI-LG. RESULTS The ipsilateral afferent lymphatic vessels, cervical draining lymph nodes and efferent lymphatic vessels were stained black orderly and constantly after Gd-Au PENPs injection. Thirty minutes after injection, all cervical lymph nodes were excised to be examined by CT/MRI scan, and only the black-stained draining lymph nodes were enhanced. The 6 rabbits with CT/MRI-LG showed clear enhancement of SLNs. With indirect lymphography, the black-stained SLNs were easily visualized at autopsy. In all rabbits, the identification rate of lingual SLNs was 100%. CONCLUSIONS Rabbit lingual SLNs could be identified with indirect lymphography using Gd-Au PENPs as a dual-mode contrast agent.
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Affiliation(s)
- Yue Yang
- Department of Otolaryngology-Head and Neck Surgery, Fudan University, Shanghai, China
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Chi Y, Huang S, Peng H, Liu M, Zhao J, Shao Z, Wu J. Critical role of CDK11(p58) in human breast cancer growth and angiogenesis. BMC Cancer 2015; 15:701. [PMID: 26470709 PMCID: PMC4608324 DOI: 10.1186/s12885-015-1698-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 10/07/2015] [Indexed: 11/24/2022] Open
Abstract
Background A capillary network is needed in cancer growth and metastasis. Induction of angiogenesis represents one of the major hallmarks of cancer. CDK11p58, a Ser/Thr kinase that belongs to the Cell Division Cycle 2-like 1 (CDC2L1) subfamily is associated with cell cycle progression, tumorigenesis, sister chromatid cohesion and apoptotic signaling. However, its role in breast cancer proliferation and angiogenesis remains unclear. Methods Tumorigenicity assays and blood vessel assessment in athymic mice were used to assess the function of CDK11p58 in tumor proliferation and angiogenesis. CCK-8 assay was used to detect breast cancer cell growth. Immunohistochemistry was used to detect the expression of vascular endothelial growth factor (VEGF), CD31 and CD34 in CDK11 positive patient breast cancer tissues. Dual-Luciferase array was used to analyze the function of CDK11p58 in the regulation of VEGF promoter activity. Western blot was used to detect related protein expression levels. Results CDK11p58 inhibited breast cancer growth and angiogenesis in breast cancer cells and in nude mice transplanted with tumors. Immunohistochemistry confirmed that CDK11p58 was negatively associated with angiogenesis-related proteins such as VEGF, CD31 and CD34 in breast cancer patients. Real-time PCR and dual-luciferase assay showed CDK11p58 inhibited the mRNA levels of VEGF and the promoter activity of VEGF. As CDK11p58 is a Ser/Thr kinase, the kinase-dead mutant failed to inhibit VEGF mRNA and promoter activity. Western blot analysis showed the same pattern of related protein expression. The data suggested angiogenesis inhibition was dependent on CDK11p58 kinase activity. Conclusion This study indicates that CDK11p58 inhibits the growth and angiogenesis of breast cancer dependent on its kinase activity. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1698-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yayun Chi
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
| | - Sheng Huang
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
| | - Haojie Peng
- School of Biomedical Engineering, hanghai Jiao Tong University, Shanghai, 200240, China.
| | - Mengying Liu
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
| | - Jun Zhao
- School of Biomedical Engineering, hanghai Jiao Tong University, Shanghai, 200240, China.
| | - Zhiming Shao
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
| | - Jiong Wu
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
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Preoperative diagnosis of sentinel lymph node (SLN) metastasis using 3D CT lymphography (CTLG). Breast Cancer 2015; 23:519-24. [PMID: 25814093 DOI: 10.1007/s12282-015-0597-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 02/16/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sentinel lymph node biopsy (SLNB) became a standard procedure for patients with early breast cancer, however, an indication of SLN navigation to metastatic disease may lead to misdiagnosis for staging. Preoperative CTLG with a water-soluble iodinated contrast medium visualizes the correct primary SLNs and its afferent lymphatic channels surrounding detailed anatomy, therefore it can predict LN metastasis by visualizing the lymph vessel obstruction or stain defect of the SLN by tumor. The current study presents the value of CTLG for preoperative prediction for SLN status. METHODS A total of 228 patients with Tis-T2 breast cancer who did not receive primary chemotherapy were studied. SLN metastasis was diagnosed according to the following staining patterns of SLNs and afferent lymphatic vessels: stain defect of SLN, obstruction, stagnation, dilation, and detour of the lymphatic vessels by tumor occupation. The diagnosis was compared with the pathological results to evaluate the accuracy of prediction for SLN metastasis using CTLG. RESULTS Twenty-seven of 228 patients had metastatic SLN pathologically. Twenty-five of these were diagnosed as metastatic preoperatively. The accuracy for metastatic diagnosis using CTLG was 89.0%, sensitivity was 92.6%, and specificity was 88.6%. The positive predictive value was 52.1% and negative predictive value was 98.8%. CONCLUSION CTLG can select the candidate with truly node negative cases in early breast cancer patients, because it predicts lymph node metastasis preoperatively from natural status of the lymphographic image. It also might omit the SLN biopsy itself.
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