In recent year, for the treatment of gastric cancer the laparoscopic surgery is performed, which has good benefits, such
as low-burden, low-invasive and the efficacy is equivalent to the open surgery. For identify location of the tumor
intraperitoneally for extirpation of the gastric cancer, several points of charcoal ink is injected around the primary tumor.
However, in the time of laparoscopic operation, it is difficult to estimate specific site of primary tumor, because the
injected charcoal ink diffusely spread to the area distant from the tumor in the stomach. Therefore, a broad area should
be resected which results in a great stress for the patients. To overcome this problem, we focused in the near-infrared
wavelength of 1000nm band which have high biological transmission. In this study, we developed a fluorescent clip
which was realized with glass phosphor (Yb3+, Nd3+ doped to Bi2O3-B2O3 based glasses. λp: 976 nm, FWHM: 100 nm,
size: 2x1x3 mm) and the laparoscopic fluorescent detection system for clip-derived near-infrared light. To evaluate
clinical performance of a fluorescent clip and the laparoscopic fluorescent detection system, we used resected stomach
(thickness: 13 mm) from the patients. Fluorescent clip was fixed on the gastric mucosa, and an excitation light (λ: 808
nm) was irradiated from outside of stomach for detection of fluorescence through stomach wall. As a result, fluorescence
emission from the clip was successfully detected. Furthermore, we confirmed that detection sensitivity of the emission of
fluorescence from the clip depends on the output power of the excitation light. We conformed that the fluorescent clip in
combination with laparoscopic fluorescent detection system is very useful method to identify the exact location of the
primary gastric cancer.
We have developed an in vivo imaging system consisting of GFP- and DsRed-tagged human colonic
cancer cell line, which has peritoneal and lymph node metastatic potential and show high sensitivity to
EGFR targeting drugs, and convenient detection devices for GFP and DsRed. The latter includes a small
handy fluorescence detection device for external monitoring of the therapeutic effect of the drug and a
convenient stereo fluorescent microscope for internal visualization of micrometastases. We applied this
imaging system to investigate anti-metastatic effects of EGFR targeting drugs such as gefitinib (Iressa).
This system allowed sensitive detection of the development of peritoneal and lymph node metastases
from the micrometastasis stage at the cellular level and also permited noninvasive, non-anesthetic
monitoring of anti-metastatic effect of the drug in an animal facility without any pretreatment. Significant
decreases in the intraabdominal metastatic tumor growth and prevention of inguinal lymph node
metastasis by gefitinib treatment could be clearly monitored. These results suggest that convenient,
low-cost, true real-time monitoring of therapeutic effect using such a fluorescence-mediated whole body
imaging system seems to enhance the speed of preclinical study for novel anti-cancer agents and will
allow us to understand the action mechanism of molecular targeting drugs.
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