Application value of indocyanine green fluorescence imaging in guiding sentinel lymph node biopsy diagnosis of gastric cancer: Meta-analysis.

BACKGROUND: Gastric cancer is a common malignant tumor of the digestive system worldwide, and its early diagnosis is crucial to improve the survival rate of patients. Indocyanine green fluorescence imaging (ICG-FI), as a new imaging technology, has shown potential application prospects in oncology surgery. The meta-analysis to study the application value of ICG-FI in the diagnosis of gastric cancer sentinel lymph node biopsy is helpful to comprehensively evaluate the clinical effect of this technology and provide more reliable guidance for clinical practice. AIM: To assess the diagnostic efficacy of optical imaging in conjunction with indocyanine green (ICG)-guided sentinel lymph node (SLN) biopsy for gastric cancer. METHODS: Electronic databases such as PubMed, Embase, Medline, Web of Science, and the Cochrane Library were searched for prospective diagnostic tests of optical imaging combined with ICG-guided SLN biopsy. Stata 12.0 software was used for analysis by combining the "bivariable mixed effect model" with the "midas" command. The true positive value, false positive value, false negative value, true negative value, and other information from the included literature were extracted. A literature quality assessment map was drawn to describe the overall quality of the included literature. A forest plot was used for heterogeneity analysis, and P < 0.01 was considered to indicate statistical significance. A funnel plot was used to assess publication bias, and P < 0.1 was considered to indicate statistical significance. The summary receiver operating characteristic (SROC) curve was used to calculate the area under the curve (AUC) to determine the diagnostic accuracy. If there was interstudy heterogeneity (I 2 > 50%), meta-regression analysis and subgroup analysis were performed. RESULTS: Optical imaging involves two methods: Near-infrared (NIR) imaging and fluorescence imaging. A combination of optical imaging and ICG-guided SLN biopsy was useful for diagnosis. The positive likelihood ratio was 30.39 (95%CI: 0.92-1.00), the sensitivity was 0.95 (95%CI: 0.82-0.99), and the specificity was 1.00 (95%CI: 0.92-1.00). The negative likelihood ratio was 0.05 (95%CI: 0.01-0.20), the diagnostic odds ratio was 225.54 (95%CI: 88.81-572.77), and the SROC AUC was 1.00 (95%CI: The crucial values were sensitivity = 0.95 (95%CI: 0.82-0.99) and specificity = 1.00 (95%CI: 0.92-1.00). The Deeks method revealed that the "diagnostic odds ratio" funnel plot of SLN biopsy for gastric cancer was significantly asymmetrical (P = 0.01), suggesting significant publication bias. Further meta-subgroup analysis revealed that, compared with fluorescence imaging, NIR imaging had greater sensitivity (0.98 vs 0.73). Compared with optical imaging immediately after ICG injection, optical imaging after 20 minutes obtained greater sensitivity (0.98 vs 0.70). Compared with that of patients with an average SLN detection number < 4, the sensitivity of patients with a SLN detection number ≥ 4 was greater (0.96 vs 0.68). Compared with hematoxylin-eosin (HE) staining, immunohistochemical (+ HE) staining showed greater sensitivity (0.99 vs 0.84). Compared with subserous injection of ICG, submucosal injection achieved greater sensitivity (0.98 vs 0.40). Compared with 5 g/L ICG, 0.5 and 0.05 g/L ICG had greater sensitivity (0.98 vs 0.83), and cT1 stage had greater sensitivity (0.96 vs 0.72) than cT2 to cT3 clinical stage. Compared with that of patients ≤ 26, the sensitivity of patients > 26 was greater (0.96 vs 0.65). Compared with the literature published before 2010, the sensitivity of the literature published after 2010 was greater (0.97 vs 0.81), and the differences were statistically significant (all P < 0.05). CONCLUSION: For the diagnosis of stomach cancer, optical imaging in conjunction with ICG-guided SLN biopsy is a therapeutically viable approach, especially for early gastric cancer. The concentration of ICG used in the SLN biopsy of gastric cancer may be too high. Moreover, NIR imaging is better than fluorescence imaging and may obtain higher sensitivity.

Synthesis of novel galactose functionalized gold nanoparticles and its radiosensitizing mechanism.

BACKGROUND: Biocompatible gold nanoparticles (GNPs) are potentially practical and efficient agents in cancer radiotherapy applications. In this study, we demonstrated that GNPs can significantly modulate irradiation response of hepatocellular carcinoma cells in vitro and investigated the underlying mechanisms. We co-grafted galactose (GAL) targeting hepatocyte specific asialoglycoprotein receptor and Polyethylene Glycol (PEG) onto GNPs surfaces to increase GNPs targeting specificity and stability. RESULTS: This novel GAL-PEG-GNPs and bare GNPs show similar appearance and cytotoxicity profiles, while more GAL-PEG-GNPs can be effectively uptaken and could enhance cancer cell killing. CONCLUSION: GAL-PEG-GNPs have better radiosensitization to HepG2. The sensitization mechanism of GAL-PEG-GNPs is related to the apoptotic gene process activated by generation of a large amount of free radicals induced by GNPs.

The role and mechanisms of nanoparticles to enhance radiosensitivity in hepatocellular cell.

OBJECTIVE: This work aimed to investigate whether nanosilver and nanogold could modulate irradiation response of hepatocellular carcinoma cells (HepG2) in vitro and the underlying mechanisms. METHODS: Cell viability of the HCC cell lines (HepG2) was examined by the 3-(4,5-dimethylthiazol-yl)-5(3-carboxymethoxyphenyl)-2H-terazolium (MTT) assays. Clonogenic growth assays of HepG2 were determined by colony formation assays. Cell apoptosis and cell cycle distribution changes were analyzed by flow cytometry (FCM). DNA damage was assessed by monitoring γ-H2AX foci in irradiated cells with immunofluorescence microscopy. The expression of regulating molecules was analyzed by using western blotting for Bax, caspase-3, and Bcl-2, and the content of catalase (Catalase CAT), superoxide dismutase (SOD), glutathione (Total of GSH) were determined. RESULTS: Our results show that nanosilver and nanogold reduced the viability of HepG2 cells. Nanosilver and nanogold significantly enhanced the radiosensitivity of HepG2 cells. Obtained by Dq, the SER of 1/5 silver+irradiation group, 1/10 silver+irradiation group, 1/5 gold+irradiation group, 1/10 gold+irradiation group, respectively, were 1.977, 1.823, 1.762, 1.597. Immunofluorescence assays showed that there was 32.2±1.2% of irradiated HepG2. And 48.1±0.1% of 1/5 IC50 nanogold+6Gy group, 43.7±0.8% of 1/10 IC50 nanogold+6Gy group, 48.8±1.2% of 1/5 IC50 nanosilver+6Gy group,41.5±1.5% of 1/10 IC50 nanosilver+6Gy group. Nanosilver and nanogold could upregulate the expression of Bax, caspase-3 and downregulate the expression of Bcl-2. Moreover, the content of CAT, SOD and Total GSH were significantly reduced. CONCLUSION: Nanosilver and nanogold could enhance the radiationsensitivity of hepatocellular carcinoma cells. Elevated DNA damage levels and apoptosis may be responsible for this.

(18)F-DG PET/CT in detection of recurrence and metastasis of colorectal cancer.

AIM: To evaluate the value of (18)F-DG PET/CT in detecting recurrence and/or metastasis of colorectal cancer (CRC). METHODS: Combined visual analysis with semiquantitative analysis, the (18)F-DG PET/CT whole-body imaging results and the corresponding clinical data of 68 postoperative CRC patients including 48 male and 20 female with average age of 58.1 were analyzed retrospectively. RESULTS: Recurrence and/or metastasis were confirmed in 56 patients in the clinical follow-up after the PET/CT imaging. The sensitivity of PET/CT diagnosis of CRC recurrence and/or metastasis was 94.6%, and the specificity was 83.3%. The positive predictive value (PPV) was 96.4% and the negative predictive value (NPV) was 76.9%. PET/CT imaging detected one or more occult malignant lesions in 8 cases where abdominal/pelvic CT and/or ultrasonography showed negative findings, and also detected more lesions than CT or ultrasonography did in 30.4% (17/56) cases. Recurrence and/or metastasis was detected in 91.7% (22/24) cases with elevated serum CEA levels by (18)F-DG PET/CT imaging. CONCLUSION: (18)F-DG PET/CT could detect the recurrence and/or metastasis of CRC with high sensitivity and specificity.