OTL-38-Guided荧光成像在肾细胞癌机械部分切除。
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巴尔CD, Maniar V,马利KN, Kheyfets SV, Shum CF,他CP
OTL-38-Guided荧光成像在肾细胞癌机械部分切除。
J Endourol B Videourol。2017年2月6日,31 (3)。pii: 10.1089 / vid.2016.0068。doi: 10.1089 / vid.2016.0068。eCollection 2017。
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32292641 (在PubMed]
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介绍和目的:叶酸受体(FR)蛋白是调节在众多上皮的恶性肿瘤,对正常组织的表达有限。FR的超表达在肾细胞癌(RCC)可以利用附加几乎任何治疗或成像代理人交付癌细胞。的首次应用,platinum-resistant卵巢癌,叶酸是用来提供聚乙二醇脂质体阿霉素(folate-linked长春花生物碱)和改善无进展生存与标准治疗。信用社被认为是第二高FR-expressing癌症。OTL-38是叶酸类似物共轭的荧光染料发光的近红外光谱。这种长波长可以深层渗透的荧光通过组织有可能更好的图像下肿瘤脂肪组织或深入实质器官。我们目前正在进行试点,第二阶段,非随机研究碾压混凝土,患者将接受主,部分或彻底的切除。目的是探索使用OTL-38和荧光成像技术观察RCC的边缘切除部分切除和淋巴结(s)或其他转移根除性肾脏切除手术。方法:目前两个病人参与试验日期与20位患者的收益目标。首先是一个67岁的男性与一个附带2.2厘米右侧肾质量,第二是一个70岁男性扩大2厘米肾质量。 Per protocol, both patients were administered OTL-38 in the preoperative area 1 hour before the procedure. Subsequently, both procedures were performed with robotic assistance as per normal routine with the use of Firefly fluorescence to aid in observation of OTL-38 uptake. Results: Intraoperative guidance through OTL-38 demonstrated minimal to no uptake of the OTL-38 as seen by Firefly fluorescence (green color). Surprisingly, the normal renal parenchyma showed strong uptake of OTL-38 as seen by Firefly fluorescence. Both pathology reports revealed conventional clear cell RCC. Immunohistochemistry slides of the tumor revealed only mild staining for folate. In contrast, immunohistochemistry slides of the normal renal parenchyma in the surgical margin revealed a strongly positive stain for folate. Conclusions: In conclusion, our first two patients' renal tumors did not stain strongly for folate; however, the normal renal parenchyma did, which served as an intraoperative guide to confirm a negative margin. Further study of patients will reveal whether folate receptors are, in fact, predominant or not in renal cell cancer. No competing financial interests exist. Runtime of video: 5 mins Presented at the World Congress of Endourology 2016 in Capetown, South Africa.
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