Application of Single-Hole Laparoscopy and Sentinel Lymph Node Imaging in Early Endometrial Carcinoma in Special Population

Aim. To explore the clinical efficacy of single-hole laparoscopy combined with sentinel lymph node imaging in the treatment of early endometrial carcinoma in a special population. Method. A retrospective analysis was made on the clinicopathological data of 8 patients with early endometrial carcinoma who underwent extra fascial total hysterectomy plus double adnexal resection and pelvic sentinel lymphadenectomy by transumbilical single-hole laparoscopy in Jiaxing Maternal and Child Health Hospital from Apr. 2019 to Apr. 2021. Result. Single-hole laparoscopy and sentinel lymph node imaging were successfully performed in 8 patients with early endometrial carcinoma, and none of them was converted to porous or laparotomy. At the same time, all 8 patients have a high demand for body shape. All FIGO pathological grades were grade I before operation. Operation time is 160.87 ± 40.61 min , amount of bleeding is 68.75 ± 12.31 ml , the catheter was removed for 2 days, anal exhaust time is 30.13 ± 10.99 h , and postoperative hospital stay is 4.00 ± 1.07 d . There was no related organ injury during the operation, no case of blood transfusion, or case of poor wound healing. The evaluation of postoperative satisfaction was very satisfactory. Conclusion. The application of single-hole laparoscopy and sentinel lymph node imaging in the treatment of early endometrial carcinoma in the special population should be safe and feasible with high satisfaction.

Optimization of Sentinel Lymph Node Imaging Methodology Using Anionic Liposome and Hyaluronidase

The sentinel lymph node (SLN) is the first lymph node into which lymphatic fluid from tumor tissues flows. The development of a highly sensitive probe for detecting SLNs is desired for the lymph node dissection through intraoperative biopsy. We have previously shown that anionic liposomes tend to accumulate in lymph nodes and that macrophage uptake of liposomes contributes to their accumulation. In the present study, we found that among anionic lipids, phosphatidylserine (PS)-containing liposomes were substantially taken up by macrophages. We identified a new lipid composition to improve the SNL-selectivity of liposome accumulation based on Design-of-Experiment. The optimized PS-containing particles were more selectively accumulate to SLN lymph nodes than existing imaging agents indocyanine green. These results indicate the effectiveness of PS-containing anionic particles in SLN imaging.

Evaluation of a streamlined sentinel lymph-node imaging protocol in early-stage oral cancer

Objective Sentinel lymph-node (SLN) mapping for early-stage oral squamous cell carcinoma (OSCC) is comprehensive and consequently time-consuming and costly. This study evaluated the clinical value of several SLN imaging components and analyzed the accuracy for SLN identification using a streamlined SLN imaging protocol in early-stage OSCC. Materials and methods This retrospective within-patient evaluation study compared both number and localization of identified SLNs between the conventional SLN imaging protocol and a streamlined imaging protocol (dynamic lymphoscintigraphy (LSG) for 10 min directly post-injection and SPECT-CT at ~ 2 h post-injection). LSG and SPECT-CT images of 77 early-stage OSCC patients, scheduled for SLN biopsy, were evaluated by three observers. Identified SLNs using either protocol were related to histopathological assessment of harvested SLNs, complementary neck dissection specimens and follow-up status. Results A total of 200 SLNs were identified using the streamlined protocol, and 12 additional SLNs (n = 212) were identified with the conventional protocol in 10 patients. Of those, 9/12 were identified on early static LSG and 3/12 on late static LSG. None of the additionally identified SLNs contained metastases; none of those in whom additional SLNs were identified developed regional recurrence during follow-up. Only inferior alveolar process carcinoma showed a higher rate of additionally identified SLNs with the conventional protocol (p = 0.006). Conclusion Early dynamic LSG can be reduced to 10 min. Late static LSG may be omitted, except in those with a history of oncological neck treatment or with OSCC featuring slow lymphatic drainage. Early static LSG appeared to be contributory in most OSCC subsites.

Preparation of Novel Bi-Modal Nano Contrast Agent and Its Application in Diagnosis of Breast Cancer

In the study, a new ultrasound contrast agent was used in the above diagnosis. Specifically, PLGA nanoparticles (PNA) loaded with Au nanorods and perfluorohexane (PFH) were prepared by the double emulsification method, and then the aptamer (APT) and PNA were connected by the carbodiimide method to obtain dualmodal ultrasound/photoacoustic targeting contrast agent (APT-PNA). Subsequently, physical characterization was performed on the prepared material, and then a fluorescence microscope was used to detect in vitro binding to breast cancer MCF-7 cells, with the normal nanoparticle group, HELA cell group, and APT interference group as controls. On this basis, it was used for the SLNB of breast cancer patients. The results showed that, the average particle size of APT-PNA was (468.5±23.6) nm, and the connection rate between the APT and the PNA reached 95.68%. After laser irradiation, the photo-induced phase changes of the APT-PNA were obvious. The APT-PNA aggregated around and bound firmly to breast cancer MCF-7 cells, while other control groups did not show obvious specific binding. After using APT-PNA, the ultrasound signal and photoacoustic signal were obviously enhanced than before irradiation. Of the 40 patients who participated in the trial, 37 developed lymphatic imaging, with an imaging rate of 92.5%, and 32 of the 37 patients with lymphatic imaging developed lymph node imaging, with a success rate of 86.5%.

J-aggregates of meso-[2.2]paracyclophanyl-BODIPY dye for NIR-II imaging

J-aggregation is an efficient strategy for the development of fluorescent imaging agents in the second near-infrared window. However, the design of the second near-infrared fluorescent J-aggregates is challenging due to the lack of suitable J-aggregation dyes. Herein, we report meso-[2.2]paracyclophanyl-3,5-bis-N,N-dimethylaminostyrl BODIPY (PCP-BDP2) as an example of BODIPY dye with J-aggregation induced the second near-infrared fluorescence. PCP-BDP2 shows an emission maximum at 1010 nm in the J-aggregation state. Mechanism studies reveal that the steric and conjugation effect of the PCP group on the BODIPY play key roles in the J-aggregation behavior and photophysical properties tuning. Notably, PCP-BDP2 J-aggregates can be utilized for lymph node imaging and fluorescence-guided surgery in the nude mouse, which demonstrates their potential clinical application. This study demonstrates BODIPY dye as an alternate J-aggregation platform for developing the second near-infrared imaging agents.

Extending the Near Infrared Emission Range of Indium Phosphide Quantum Dots for Multiplexed In Vivo Imaging

This report of the reddest emitting indium phosphide quantum dots (InP QDs) to date demonstrates tunable, near infrared (NIR) photoluminescence and fluorescence multiplexing in the first optical tissue window with a material that avoids toxic constituents. This synthesis overcomes the InP synthesis “growth bottleneck” and extends the emission peak of InP QDs deeper into the first optical tissue window using an inverted QD heterostructure. The ZnSe/InP/ZnS core/shell/shell structure is designed to produce emission from excitons with heavy holes confined in InP shells wrapped around larger-bandgap ZnSe cores and protected by a second shell of ZnS. The InP QDs exhibit InP shell thickness-dependent tunable emission with peaks ranging from 515 – 845 nm. The high absorptivity of InP leads to effective absorbance and photoexcitation of the QDs with UV, visible, and NIR wavelengths in particles with diameters of eight nanometers or less. These nanoparticles extend the range of tunable direct-bandgap emission from InP-based nanostructures, effectively overcoming a synthetic barrier that has prevented InP-based QDs from reaching their full potential as NIR imaging agents. Multiplexed lymph node imaging in a mouse model shows the potential of the NIR-emitting InP particles for in vivo imaging.

J-Aggregates of meso- [2.2] Paracyclophanyl-BODIPY Dye for NIR-II Imaging

J-aggregation has been proved to be an efficient strategy for the development of fluorescent imaging agents in the second near-infrared (NIR-II, 1000–1700 nm) window. However, the design of NIR-II fluorescent J-aggregates is challenging due to the lack of suitable J-aggregation dyes. Herein, we report meso-[2.2]paracyclophanyl-3,5-bis-N,N-dimethylaminostyrl BODIPY (PCP-BDP2) as the first example of BODIPY dye with J-aggregation induced NIR-II fluorescence. PCP-BDP2 shows emission maximum at 795 nm in diluted solution and NIR-II emission at 1010 nm in the J-aggregation state. Mechanism studies reveal that the steric and conjugation effect of the PCP group on the BODIPY core plays key roles in the J-aggregation behavior and NIR-II fluorescence tuning. Notably, NIR-II emissive J-aggregates of PCP-BDP2 can be efficiently stabilized in the assembled nanoparticle. Taking advantage of high quantum yield and good photo-/chemo-stability, J-aggregates of PCP-BDP2 show high-resolution and long-term in vivo NIR-II imaging ability. Furthermore, J-aggregates of PCP-BDP2 can be utilized for lymph node imaging and fluorescence-guided surgery in the nude mouse, which demonstrates their potential clinical application. This study not only demonstrates BODIPY dye as a new J-aggregation platform for developing NIR-II imaging agents but also encourages further exploration on J-aggregation induced NIR-II emission of the other conventional organic dyes.