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Prospective feasibility study for single-tracer sentinel node mapping by ICG (indocyanine green) fluorescence and OSNA (one-step nucleic acid amplification) assay in laparoscopic gastric cancer surgery
摘要： Background The double-tracer method has been established for sentinel node (SN) mapping in gastric cancer surgery. However, there remain several unresolved issues that prevent its widespread use in clinical practice. In this study, we aimed to demonstrate the feasibility of single-tracer SN mapping in laparoscopic surgery for gastric cancer, using indocyanine green (ICG) fluorescence imaging with a one-step nucleic acid amplification (OSNA) assay intraoperatively. Methods Patients with clinical T1N0M0 gastric adenocarcinoma preoperatively were considered for inclusion if they had a single primary lesion 4 cm or less in maximal diameter. Immunohistochemical staining with the anti-cytokeratin 19 antibody was performed on preoperative biopsy specimens, and patients with faint positive reactions were excluded. Intraoperatively, single-tracer SN biopsy with ICG fluorescence imaging was performed, followed by laparoscopic gastrectomy with modified D1+ or D2 lymph node dissection. Results Twenty eligible patients underwent SN biopsy and laparoscopic gastrectomy. SNs were identified in 17 cases (85%), with a median number of three SNs per patient. The median times for SN mapping and OSNA assay were 19 and 35 min, respectively. OSNA assay detected one metastatic lymph node, but all other nodes were negative. No adverse effects were observed in relation to SN mapping. Conclusions Single-tracer SN mapping by ICG fluorescence imaging with intraoperative diagnosis by OSNA assay is feasible and safe. SNs can be identified in most patients, without producing false-negative results. Further clinical trial to demonstrate the sensitivity is ongoing.
关键词： Fluorescence imaging,Indocyanine green,Sentinel lymph node,Surgical pathology,Gastric cancer
更新于2025-09-23 15:23:52
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[IEEE 2018 International Conference and Exposition on Electrical And Power Engineering (EPE) - Iasi, Romania (2018.10.18-2018.10.19)] 2018 International Conference and Exposition on Electrical And Power Engineering (EPE) - Advanced Image Processing in Support of THz Imaging for Early Detection of Gastric Cancer
摘要： Gastric tumors are still late diagnosed and represent min. 17% of cases leading to metastasis. The ability to visualize the mucosa of the gastrointestinal tract in detail is a requisite for early detection of dysplasia and cancer. Although techniques such as chromoendoscopy, high resolution and magnification endoscopy, narrow band imaging, auto-fluorescence imaging improve the visualization and detection of mucosal lesions, biopsy of the targeted lesion must still be performed for a formal histological diagnosis of cellular and architectural atypical.
关键词： gastric cancer,image processing,THz imaging
更新于2025-09-23 15:22:29
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Near-infrared fluorescence-guided surgery using indocyanine green facilitates secure infrapyloric lymph node dissection during laparoscopic distal gastrectomy
摘要： Purpose We aimed to investigate the usefulness of near-infrared indocyanine green (ICG)-enhanced fluorescence guidance for infrapyloric LN dissection in laparoscopic distal gastrectomy. Methods This study enrolled patients with early gastric cancer scheduled for laparoscopic distal gastrectomy. After intra-operative submucosal injection of ICG (0.1 mg/mL), LN dissection was conducted under near-infrared ICG fluorescence guidance. The operation time, bleeding events during infrapyloric LN dissection were analyzed. Cases were retrospectively 1:3 propensity-score matched to patients who underwent laparoscopic distal gastrectomy without ICG injection. Results The mean time from midline omentectomy to exposure of the right gastroepiploic vein was significantly shorter in the ICG group (n = 20) than in the non-ICG group (n = 60) (13.05 ± 5.77 vs 18.68 ± 7.92 min; p = 0.001), and the incidence of bleeding during infrapyloric LN dissection was lower in the ICG group (20% vs 68.3%, p < 0.001). The two groups did not differ significantly regarding the number of LNs retrieved from the infrapyloric area (p = 0.434). Conclusions Near-infrared ICG fluorescence guidance facilitates safe and fast infrapyloric LN dissection in laparoscopic distal gastrectomy.
关键词： Indocyanine green,Laparoscopic surgery,Lymph node dissection,Near-infrared imaging,Gastric cancer
更新于2025-09-23 15:21:01
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Probe-based confocal laser endomicroscopy versus biopsies in the diagnostics of oesophageal and gastric lesions: A prospective, pathologist-blinded study
摘要： Background and aim: Probe-based confocal laser endomicroscopy (pCLE) provides real-time microscopic visualisation. Our aim was to compare the diagnostic accuracy of pCLE with standard biopsies in patients with visible oesophageal or gastric lesions. Methods: This was a single-centre, prospective, pathologist-blinded study. Patients underwent high-resolution endoscopy, and lesions were examined by pCLE followed by standard biopsies. A definitive diagnosis was determined from resection specimen. Main outcomes were overall diagnostic accuracy, sensitivity, specificity and positive and negative predictive values. Results: We examined 74 lesions in 67 patients. Definitive diagnoses revealed 34 malignant and 40 non-malignant lesions. pCLE diagnosis was correct in 89.2% (66/74), while diagnosis based on biopsy was correct in 85% (57/67; p ? 0.6). The overall diagnostic accuracy of biopsies was 85% (76–94%) and that of pCLE was 89% (79–96%). pCLE correctly diagnosed malignant lesions, comprising oesophageal adenocarcinoma, oesophageal squamous-cell cancer or gastric adenocarcinoma, in 88.2% (30/34) of cases, while biopsy was correctly diagnosed in 75.9% (22/29; p ? 0.3). Sensitivity and specificity to diagnose a malignant lesion were 75.9% (95% confidence interval (CI) 56–89%) and 100% (95% CI 90–100%) for biopsies and 88.2% (95% CI 72–97%) and 92% (95% CI 79–98%) for pCLE. No differences between biopsies and pCLE were found with regard to sensitivity, specificity to diagnose dysplastic and benign lesions (p > 0.2). Conclusion: pCLE provides satisfactory diagnostic accuracy comparable with standard biopsies in patients with oesophageal or gastric lesions. ClinicalTrials.gov identifier: NCT0292049)
关键词： Confocal laser endomicroscopy,oesophageal and gastric cancer
更新于2025-09-23 15:19:57
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Visible Light-Driven Self-Powered Device Based on a Straddling Nano-Heterojunction and Bio-Application for the Quantitation of Exosomal RNA
摘要： This paper reports the design and fabrication of a self-powered biosensing device based on TiO2 nanosilks (NSs)@MoS2 quantum dots (QDs) and demonstrates a bio-application for the quantitative detection of exosomal RNA (Homo sapiens HOXA distal transcript antisense RNA (HOTTIP)). This self-powered device features enhanced power output, compared to TiO2 NSs alone. This is attributed to the formation of a heterojunction structure with suitable band offset derived from the hybridization between TiO2 NSs and MoS2 QDs, i.e., the straddling (Type I) band alignment. The sensitization effect and excellent visible light absorption provided by MoS2 QDs can prolong interfacial carrier lifetime and improve energy conversion efficiency. This self-powered biosensing device has been successfully applied in quantitative HOTTIP detection through effective hybridization between a capture probe and HOTTIP. The successful capture of HOTTIP leads to a sequential decrease in power output, which is utilized for ultrasensitive quantitative HOTTIP detection, with a linear relationship of power output change vs. logarithm of HOTTIP concentration ranging from 5 fg/mL to 50000 ng/mL and a detection limit as low as 5 fg/mL. This TiO2 NSs@MoS2 QDs-based nanomaterial has excellent potential for a superior self-powered device characterized by economical and portable self-powered biosensing. Moreover, this self-powered, visible light-driven device shows promising applications for cancer bio-marker quantitative detection.
关键词： self-power,gastric cancer,heterojuncture,TiO2@MoS2,exosome,homo sapiens HOXA distal transcript antisense RNA(HOTTIP)
更新于2025-09-19 17:15:36
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Early gastric cancer detection in high-risk patients: a multicentre randomised controlled trial on the effect of second-generation narrow band imaging
摘要： Objective early detection of gastric cancer has been the topic of major efforts in high prevalence areas. Whether advanced imaging methods, such as second-generation narrow band imaging (2g- nBi) can improve early detection, is unknown. Design This open-label, randomised, controlled tandem trial was conducted in 13 hospitals. Patients at increased risk for gastric cancer were randomly assigned to primary white light imaging (Wli) followed by secondary 2g- nBi (Wli group: n=2258) and primary 2g- nBi followed by secondary Wli (2g- nBi group: n=2265) performed by the same examiner. suspected early gastric cancer (egc) lesions in both groups were biopsied. Primary endpoint was the rate of egc patients in the primary examination. The main secondary endpoint was the positive predictive value (PPV) for egc in suspicious lesions detected (primary examination). results egcs were found in 44 (1.9%) and 53 (2.3%; p=0.412) patients in the Wli and 2g- nBi groups, respectively, during primary egD. in a post hoc analysis, the overall rate of lesions detected at the second examination was 25% (n=36/145), with no significant differences between groups. PPV for egc in suspicious lesions was 13.5% and 20.9% in the Wli (50/371 target lesions) and 2g- nBi groups (59/282 target lesions), respectively (p=0.015). Conclusion The overall sensitivity of primary endoscopy for the detection of egc in high- risk patients was only 75% and should be improved. 2g- nBi did not increase egc detection rate over conventional Wli. The impact of a slightly better PPV of 2g- nBi has to be evaluated further.
关键词： positive predictive value,narrow band imaging,early gastric cancer,detection rate,white light imaging
更新于2025-09-19 17:13:59
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111In-labeled anti-cadherin17 antibody D2101 has potential as a noninvasive imaging probe for diagnosing gastric cancer and lymph-node metastasis
摘要： Objective Cadherin-17 (CDH17) is a transmembrane protein that mediates cell–cell adhesion and is frequently expressed in adenocarcinomas, including gastric cancer. CDH17 may be an effective diagnostic marker for the staging of gastric cancer. Here, we developed an 111In-labeled anti-CDH17 monoclonal antibody (Mab) as an imaging tracer and performed biodistribution and single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging studies using mice with CDH17-positive gastric cancer xenografts. CDH17 expression in gastric cancer specimens was also analyzed. Methods The cross-reactivity and affinity of our anti-CDH17 Mab D2101 was evaluated by surface plasmon resonance analysis and cell enzyme-linked immunosorbent assay, respectively. Biodistribution and SPECT/CT studies of 111In-labeled D2101 (111In-D2101) were performed. CDH17 expression in gastric cancer specimens was evaluated by immunohistochemistry. Results Surface plasmon resonance analysis revealed that D2101 specifically recognizes human CDH17, but not murine CDH17. The affinity of D2101 slightly decreased as a result of the radiolabeling procedures. The biodistribution study revealed high uptake of 111In-D2101 in tumors (maximum, 39.2 ± 9.5% ID/g at 96 h postinjection), but low uptake in normal organs, including the stomach. Temporal SPECT/CT imaging with 111In-D2101 visualized tumors with a high degree of tumor-to-nontumor contrast. Immunohistochemical analysis revealed that, compared with HER2, which is a potential marker of N-stage, CDH17 had a higher frequency of positivity in specimens of primary and metastatic gastric cancer. Conclusion Our 111In-anti-CDH17 Mab D2101 depicted CDH17-positive gastric cancer xenografts in vivo and has the potential to be an imaging probe for the diagnosis of primary lesions and lymph-node metastasis in gastric cancer.
关键词： Cadherin-17,Radiolabeled antibody,Lymph-node metastasis,SPECT,Gastric cancer
更新于2025-09-16 10:30:52
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The feasibility of low-dose CT perfusion imaging in gastric cancer
摘要： PURPOSE: To investigate feasibility of applying low-dose CT perfusion imaging (CTPI) to diagnose gastric cancer. MATERIALS AND METHODS: Twenty patients with gastric cancer con?rmed by endoscopic biopsy were undergone routine dose (120 kV, 100 mA) and low-dose (120 kV, 50 mA) CTPI examination, respectively. The original data were processed by body perfusion software, and the perfusion parameters values including blood ?ow (BF), blood volume (BV) and permeability surface (PS) of gastric cancer were measured. Statistical data analyses including paired-samples t test, Pearson correlation analysis and Bland-Altman consistency test were used to compare the perfusion parameters values between the routine dose and low-dose CTPI examinations. Radiation dosage, which the patients received during two CTPI examinations, was also calculated and compared. RESULTS: There were no statistical differences in the BF, BV and PS values between routine dose group and low-dose group (P > 0.05), and there were signi?cant correlation in the BF, BV and PS values between two groups (P < 0.01). The consistency of BF and BV values between the two groups was preferable to that of PS value. The radiation dosage of the low-dose group was much less than that of routine dose group, and the CTDIvol and DLP values of low-dose CTPI were decreased by 50%, respectively. CONCLUSION: The parameters BF and BV values may play a valuable role in the diagnosis and assessment of gastric cancer in low-dose CTPI examination.
关键词： gastric cancer,computed tomography,Low-dose,perfusion imaging
更新于2025-09-10 09:29:36
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Dual Energy Spectral CT Imaging in the assessment of Gastric Cancer and cell proliferation: A Preliminary Study
摘要： Gastric cancer is one of the main diseases leading to cancer-related death. The recently introduced dual-energy spectral CT (DEsCT), allows to obtain many quantitative measurements from iodine-based material decomposition (MD) images, which contribute to improve the accuracy of staging of GC comparing to multidetector spiral CT. And Ki-67 is a well-recognized nuclear antigen-specific biomarker reflecting cellular proliferation for estimating growth fractions of various tumor types. In the present study we analyzed the features of quantitative measurements (the curve slope (λHU), IC, normalized iodine concentrations (NIC)) obtained from DEsCT and levels of Ki-67 protein expression. We demonstrated that the values between advanced gastric cancer (AGC) and early gastric cancer (EGC) were significantly different both in venous phase (VP) and delayed phase (DP). The values of different level of Ki-67 expression grade were significantly different both in VP and DP. The rank correlation analysis between Ki-67 grade and IC, NIC and λHU values showed significantly positive correlation in VP and DP. These results suggested that quantitative parameters (IC, NIC and λHU) in dual-energy CT imaging can be used to differentiate EGC from AGC, and have significantly positive correlation with Ki-67 antigen expression levels in gastric cancer for indicating tumor cellular proliferation.
关键词： Gastric cancer,dual-energy spectral CT,Ki-67,iodine concentration,cellular proliferation
更新于2025-09-09 09:28:46