Radioguided Detection of Lymph Node Metastasis in Non-Small Cell Lung Cancer

非小细胞肺癌淋巴结转移的放射引导检测

• 批准号: 7472668
• 负责人: CHUKWUMERE E. NWOGU
• 金额: $ 14.85万
• 依托单位: ROSWELL PARK CANCER INSTITUTE CORP
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7472668
• 关键词: Biological Assay; Biological Markers; Cancer Etiology; Cancer Patient; Categories; Cessation of life; Clinical; Clinical Trials; Cyclin E; Detection; Diagnostic Neoplasm Staging; Enrollment; Gamma Rays; Goals; Hand; Hematoxylin and Eosin Staining Method; Histologic; Immunohistochemistry; Individual; Injection of therapeutic agent; Intravenous; Malignant Epithelial Cell; Malignant Neoplasms; Malignant neoplasm of lung; Measures; Metastatic Carcinoma; Methods; Micrometastasis; Microscopic; Neoplasm Metastasis; Non-Small-Cell Lung Carcinoma; Numbers; Pathologic; Patients; Positron; Positron-Emission Tomography; Primary Neoplasm; Program Development; Quality of life; Radioactivity; Recurrence; Research Personnel; Research Project Grants; Resectable; Staging; Staining method; Stains; Standards of Weights and Measures; Stratification; Structure of lymph node of thorax; Techniques; Therapeutic; Tomogram; Tumor stage; United States; Vascular Endothelial Growth Factors; Woman; X-Ray Computed Tomography; career; clinically relevant; cost; cyclin B1; design; fluorodeoxyglucose; improved; intravenous injection; lymph nodes; men; patient oriented; prognostic; survivin; tumor

DESCRIPTION (provided by applicant): Lung cancer is the most frequent cause of cancer death in both men and women in the United States. Lymph node staging provides the most important prognostic information in patients with locoregional non-small cell lung cancer (NSCLC). Current methods of evaluating lymph nodes (hematoxylin-eosin staining) can miss micrometastases. Our first aim is to establish the utility of an intra-operative gamma probe to detect intravenously injected 18F-Fluorodeoxygulcose (FDG) in thoracic lymph nodes, thus improving the accuracy of lymph node staging in NSCLC. The potential ability of molecular markers to stratify patients with NSCLC into good and poor prognostic groups can alter therapeutic choices for individual patients. Thus, our second aim is to identify biological markers that may predict lymph node metastases (including micrometastases). We intend to achieve these goals by conducting a clinical trial involving 100 patients with resectable NSCLC. All the patients will have a pre-operative positron emission tomogram (PET). The PET-determined stage of the tumor will be compared with the stage determined by the use of an intra-operative gamma probe after intravenous FDG injection. The ability of the gamma probe to guide the detection of micrometastases will be assessed. Routine histologic staining of nodes will be compared to ultrastaging of the lymph node using intensive pathologic techniques. Assays of 4 biomarkers - cyclin B1, cyclin E, survivin and vascular endothelial growth factor (VEGF) - in the primary tumors will be done and correlated with lymph node metastases. This research project will be an integral part of a comprehensive career development program designed to prepare me as an independent patient-oriented investigator. This study is designed to detect microscopic spread of lung cancer to lymph nodes and to molecularly predict the aggressiveness of the cancer. This information will then facilitate therapeutic decisions.

描述（由申请人提供）：肺癌是美国男性和女性癌症死亡的最常见原因。淋巴结分期为局部非小细胞肺癌 (NSCLC) 患者提供最重要的预后信息。目前评估淋巴结的方法（苏木精-伊红染色）可能会漏掉微转移。我们的首要目标是建立术中伽马探针的实用性，以检测胸部淋巴结中静脉注射的 18F-氟脱氧葡萄糖 (FDG)，从而提高 NSCLC 淋巴结分期的准确性。分子标志物将 NSCLC 患者分为预后良好组和预后不良组的潜在能力可以改变个体患者的治疗选择。因此，我们的第二个目标是确定可以预测淋巴结转移（包括微转移）的生物标志物。我们打算通过开展一项涉及 100 名可切除 NSCLC 患者的临床试验来实现这些目标。所有患者都将接受术前正电子发射断层扫描（PET）。将 PET 确定的肿瘤分期与静脉注射 FDG 后使用术中伽马探针确定的分期进行比较。将评估伽玛探针指导微转移检测的能力。将常规的淋巴结组织学染色与使用强化病理技术进行的淋巴结超分期进行比较。将对原发肿瘤中的 4 种生物标志物（细胞周期蛋白 B1、细胞周期蛋白 E、生存素和血管内皮生长因子 (VEGF)）进行检测，并将其与淋巴结转移相关联。该研究项目将成为综合职业发展计划的一个组成部分，该计划旨在让我成为一名以患者为中心的独立研究者。这项研究旨在检测肺癌向淋巴结的微观扩散，并从分子上预测癌症的侵袭性。这些信息将有助于做出治疗决策。