Antineoplastic activity of povidone-iodine on different mesothelioma cell lines: results of in vitro study.

OBJECTIVE: Povidone-iodine (PVP-I) or Betadine, owing to its antineoplastic activity, is also used as an adjuvant during intra-abdominal or intrathoracic surgery. However, the protocol of PVP-I administration has not been optimized to achieve the best antitumoural efficacy. We aimed to determine the optimal concentration of PVP-I, the time of incubation and the mechanism of cell death by analysing the effect of different doses and time of administration of PVP-I on the cell viability of different mesothelioma cell lines. METHODS: Four different cell lines (MET 5A/normal mesothelium; H2052/sarcomatoid mesothelioma; ISTMES2/epithelial mesothelioma; MSTO/biphasic mesothelioma) were incubated with increasing concentrations of diluted PVP-I (0.0001; 0.001; 0.01; 0.1; 1%) for 5, 10, 30, 60 min and 24 h, respectively. Cell viability was determined using cell direct cytotoxicity assay and cell death was determined through flow cytometry assay analysis. The superoxide dismutase activity was assessed functionally through a specific inhibitor to evaluate the mechanism of cell death. RESULTS: The antiproliferative effect of PVP-I varied largely among different cell lines in a dose- and time-dependent manner. At 0.1% concentration for 10 min of incubation, the percentage of viable cells was 0.5 ± 0.1; 0.8 ± 0.5 and 0% (P < 0.01) for MET5A, ISTMES2 and MSTO, respectively. Conversely, the same concentration did not significantly affect the H2052 cell line which was completely suppressed at a 1% concentration of PVP-I. Double staining of Annexin V and DNA showed that PVP-I induced cell death in all four cell lines via necrosis depending on PVP-I concentration. However, H2052 was found to be more resistant than MSTO, ISTMES2 and MET 5A cells lines. The activity of superoxide dismutase was significantly inhibited in all cell lines. CONCLUSIONS: Our results confirmed the anti-neoplastic activity of PVP-I especially on ISTMES2 and MSTO cell lines. With respect to chemotherapy pleural irrigation, washing with PVP-I is cost-effective and easy. If confirmed by larger studies, our findings suggest that the intrapleural irrigation with PVP-I (0.1% concentration for 10 min) in patients with epithelial or biphasic mesothelioma undergoing cytoreductive surgery might be applied in thoracic surgery practice to prevent neoplastic cell growth.

Uso combinado de aspiración por punción transbronquial y tomografía computarizada de emisión fotónica única con 99mTc-2-metoxi-isobutil-isonitrilo para el diagnóstico de ganglios linfáticos mediastínicos agrandados / Combined Transbronchial Needle Aspiration and 99mTc-2-Methoxy-Isobutyl-Isonitrile Single Photon Emission Computed Tomography for Diagnosing Enlarged Mediastinal Lymph Nodes

ANTECEDENTES: Demostrar la exactitud diagnóstica de un abordaje integrado del diagnóstico de las adenopatías mediastínicas mediante aspiración por punción transbronquial (TBNA) ciega y tomografía computarizada de emisión fotónica única con 99mTc-2-metoxi-isobutil-isonitrilo (99mTc-MIBI-SPECT). MÉTODOS: Se incluyó prospectivamente en el estudio a 61 pacientes consecutivos con adenopatías mediastínicas a los que se practicó una TBNA y una 99mTc-MIBI-SPECT. En el caso de que la TBNA fuera negativa se realizaba una mediastinoscopia. RESULTADOS: Se obtuvieron muestras de 83 adenopatías (73 malignas y 10 benignas). La sensibilidad, la especificidad, el valor predictivo positivo (VPP) y el valor predictivo negativo (VPN) de la TBNA fueron del 74, del 100%, del 100 y del 34%, respectivamente, y las de la 99mTc-MIBI-SPECT fueron del 96, del 80, del 97 y del 73%, respectivamente. La combinación de TBNA y 99mTc-MIBI-SPECT alcanzó una sensibilidad, especificidad, VPP y VPN del 97, del 100, del 100 y del 83%, respectivamente. La TBNA sola evitó la mediastinoscopia en el 65% de los casos, mientras que un abordaje integrado podría haber obviado la mediastinoscopia en el 76% de los casos. CONCLUSIONES: La 99mTc-MIBI-SPECT mejoró la sensibilidad y el VPN de la TBNA, reduciendo la necesidad de realizar mediastinoscopias

BACKGROUND: To demonstrate the diagnostic accuracy of an integrated approach of blind trans-bronchial needle aspiration (TBNA) and 99mTc-2-methoxy-isobutyl-isonitrile single photon emission computed tomography (99mTc-MIBI-SPECT) in diagnosing mediastinal lymph adenopathy. METHODS: Sixty one consecutive patients with mediastinal lymph adenopathy undergoing both TBNA and99mTc-MIBI-SPECT were prospectively enrolled. Mediastinoscopy was attended in case of negative TBNA. RESULTS: Eighty three adenopathies were sampled (73 malignant and 10 benign). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of TBNA was 74%, 100%, 100%, and 34%,respectively; and of 99mTc-MIBI-SPECT was 96%, 80%, 97%, and 73%, respectively. Combining TBNA and 99mTc-MIBI-SPECT results sensitivity, specificity, PPV, NPV of 97%, 100%, 100%, and 83%, respectively, was obtained. TBNA alone avoided medistianoscopy in 65% of cases, while an integrated approach could have potentially obviated mediastinoscopy in 76%. CONCLUSIONS: 99mTc-MIBI-SPECT improved the sensitivity and the NPV of TBNA, reducing the need of mediastinoscopy

Combined transbronchial needle aspiration and (99m)Tc-2-methoxy-isobutyl-isonitrile single photon emission computed tomography for diagnosing enlarged mediastinal lymph nodes.

BACKGROUND: To demonstrate the diagnostic accuracy of an integrated approach of blind trans-bronchial needle aspiration (TBNA) and (99m)Tc-2-methoxy-isobutyl-isonitrile single photon emission computed tomography ((99m)Tc-MIBI-SPECT) in diagnosing mediastinal lymph adenopathy. METHODS: Sixty one consecutive patients with mediastinal lymph adenopathy undergoing both TBNA and (99m)Tc-MIBI-SPECT were prospectively enrolled. Mediastinoscopy was attended in case of negative TBNA. RESULTS: Eighty three adenopathies were sampled (73 malignant and 10 benign). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of TBNA was 74%, 100%, 100%, and 34%, respectively; and of (99m)Tc-MIBI-SPECT was 96%, 80%, 97%, and 73%, respectively. Combining TBNA and (99m)Tc-MIBI-SPECT results sensitivity, specificity, PPV, NPV of 97%, 100%, 100%, and 83%, respectively, was obtained. TBNA alone avoided medistianoscopy in 65% of cases, while an integrated approach could have potentially obviated mediastinoscopy in 76%. CONCLUSIONS: (99m)Tc-MIBI-SPECT improved the sensitivity and the NPV of TBNA, reducing the need of mediastinoscopy.