Impact of diagnostic peritoneal lavage on omentum metastasis

诊断性腹腔灌洗对大网膜转移的影响

• 批准号: 10447751
• 负责人: Honami Naora
• 金额: $ 8.1万
• 依托单位: UNIVERSITY OF TX MD ANDERSON CAN CTR
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-08 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10447751
• 关键词: Acidosis; Address; Adipose tissue; Adverse effects; Advocate; Affect; Allografting; Blood Vessels; Body Fluids; Buffers; Cancer Biology; Cancer Patient; Cells; Cellular Structures; Chlorides; Clinical; Clinical Trials; Critical Care; Cytology; Diagnosis; Diagnostic; Diagnostic Neoplasm Staging; Diagnostic Procedure; Dose; Drainage procedure; Electrolytes; Excision; Fostering; Goals; Greater sac of peritoneum; Growth; Growth Factor; Immune; Implant; Inflammatory; Inflammatory Response; Infusion procedures; Intestinal Obstruction; Irrigation; Lactated Ringer' s Solution; Lead; Liquid substance; Literature; Malignant Neoplasms; Malignant neoplasm of abdomen; Malignant neoplasm of gastrointestinal tract; Malignant neoplasm of ovary; Modeling; Mus; NOS2A gene; Neoplasm Metastasis; Normal saline; Omentum; Osmolalities; Pain; Peritoneal; Peritoneal lavage; Physiological; Play; Prevention; Procedures; Property; Publishing; Reporting; Risk; Role; Saline; Site; Sodium; Sodium Chloride; Spottings; Staging; Stomach; Time; angiogenesis; base; cancer cell; circulating cancer cell; clinically relevant; cost effective; density; experience; implantation; improved; in vivo; innovation; preservation; prevent; prophylactic; response; risk minimization; tumor

PROJECT SUMMARY/ABSTRACT The omentum is an immune cell-rich fatty tissue that suspends from the stomach and plays an important role in peritoneal defense. The omentum is the predominant site of ovarian cancer metastasis, and metastasis to the omentum can lead to fatal bowel obstruction. Although surgical removal of the omentum has been advocated for cancer patients who do not present with overt omental metastasis, this prophylactic procedure has been contentious. The over-arching goal of this study is to identify approaches to minimize the risk of omental metastasis by occult circulating cancer cells when the omentum is preserved. Peritoneal lavage is a diagnostic procedure that is performed as part of abdominal cancer staging in which saline solution is administered into the peritoneal cavity and the washings are cytologically examined. Saline solution has also been widely used for i.v. fluid and electrolyte replenishment. Studies of infusion in the critical care setting have shown that the main adverse effect of saline solution is hyperchloremic acidosis, and there is evidence that acidosis can activate inflammatory responses that foster a cancer-permissive milieu. Because the omentum has immense capability to absorb fluid in the peritoneal cavity, we speculate that the omentum might be deleteriously affected by peritoneal lavage with saline solution. Based on these prior reports and our preliminary studies, we hypothesize that peritoneal lavage with saline solution stimulates the omentum to become conducive for implantation of occult cancer cells. In this study, we will evaluate the impact of peritoneal lavage with saline solution on cellular constituents of the omentum and inflammatory responses, and determine whether this lavage stimulates implantation of circulating cancer cells on the omentum in mouse allograft models of ovarian cancer. Importantly, we will also determine whether the risk of omental metastasis can be minimized by using buffered solutions instead of saline for peritoneal lavage. If successful, our study will provide a new and important rationale for revising diagnostic and staging practices to reduce the risk of metastasis to the omentum when this site is preserved.

项目摘要/摘要 omentum是一种富含免疫细胞的脂肪组织，可从胃中悬浮并在 腹膜防御。 omentum是卵巢癌转移的主要部位，转移到 大脑会导致致命的肠梗阻。尽管已提倡手术去除大脑 对于不出现明显粘性转移的癌症患者，这种预防性程序已经是 有争议这项研究的整理目标是确定方法以最大程度地降低肿瘤的风险 保留脑膜时通过神秘循环癌细胞的转移。腹膜灌洗是一种诊断 作为腹部癌症分期的一部分进行的程序，将盐溶液施用到 腹膜腔和洗涤物进行了细胞学检查。盐溶液也已被广泛使用 对于I.V.液体和电解质补充。重症监护环境中输注的研究表明 盐水溶液的主要不利作用是高氯性酸中毒，有证据表明酸中毒可以 激活炎症反应，以促进癌症的环境。因为大脑具有巨大的 我们可以在腹膜腔中吸收液体的能力，我们推测大脑可能是有害的 受盐水溶液的腹膜灌洗的影响。基于这些先前的报告和我们的初步研究，我们 假设用盐水溶液腹膜灌洗可以刺激脑类的利益 神秘癌细胞的植入。在这项研究中，我们将评估腹膜灌洗的影响 溶液在足体和炎症反应的细胞成分上，并确定这是否是 灌洗刺激在小鼠同种异体移植卵巢模型中植入循环癌细胞 癌症。重要的是，我们还将确定是否可以通过使用膜转移的风险来降至最低 缓冲溶液而不是盐水用于腹膜灌洗。如果成功的话，我们的研究将提供一个新的和 修改诊断和分期实践的重要理由，以降低转移风险 保留此站点时。