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VEGFR2 靶向微泡超声分子成像提高微侵袭性宫颈癌的诊断灵敏度。

VEGFR2 targeted microbubble-based ultrasound molecular imaging improving the diagnostic sensitivity of microinvasive cervical cancer.

机构信息

Department of Ultrasound, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.

Department of Pathology, The Third Affiliated Hospital of Sun Yat-sen University, No. 600 Tianhe Road, Guangzhou, 510630, Guangdong, China.

出版信息

J Nanobiotechnology. 2023 Jul 12;21(1):220. doi: 10.1186/s12951-023-01984-2.

Abstract

BACKGROUND

The current diagnostic methods of microinvasive cervical cancer lesions are imaging diagnosis and pathological evaluation. Pathological evaluation is invasive and imaging approaches are of extremely low diagnostic performance. There is a paucity of effective and noninvasive imaging approaches for these extremely early cervical cancer during clinical practice. In recent years, ultrasound molecular imaging (USMI) with vascular endothelial growth factor receptor type 2 (VEGFR2) targeted microbubble (MB) has been reported to improve the early diagnosis rates of breast cancer (including ductal carcinoma in situ), pancreatic cancer and hepatic micrometastases. Herein, we aimed to assess the feasibility of MB-based USMI in extremely early cervical cancer detection to provide an accurate imaging modality for microinvasive cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) Stage IA1 and IA2).

RESULTS

We found MB-based USMI could successfully distinguish extremely early lesions in diameter < 3 mm from surrounding normal tissues (all P < 0.05), and the sensitivity gradually decreased along with increasing tumor diameter. Moreover, normalized intensity difference (NID) values showed a good linear correlation with microvessel density (MVD) (R = 0.75). In addition, all tumors could not be identified from surrounding muscles in subtracted ultrasound images when mice were administered MB.

CONCLUSIONS

Overall, MB-based USMI has huge potential for clinical application for the early detection of microinvasive cervical cancer (FIGO Stage IA1 and IA2), providing the foothold for future studies on the imaging screening of this patient population.

摘要

背景

目前,宫颈微小浸润性病灶的诊断方法主要为影像学诊断和病理学评估。病理学评估具有侵袭性,而影像学方法的诊断性能极低。在临床实践中,对于这些极早期的宫颈癌,缺乏有效的、非侵入性的影像学方法。近年来,超声分子成像(USMI)联合血管内皮生长因子受体 2(VEGFR2)靶向微泡(MB)已被报道可提高乳腺癌(包括导管原位癌)、胰腺癌和肝微转移的早期诊断率。在此,我们旨在评估基于 MB 的 USMI 在极早期宫颈癌检测中的可行性,为宫颈微小浸润性癌(国际妇产科联合会(FIGO)分期 IA1 和 IA2)提供一种准确的影像学方法。

结果

我们发现 MB 基 USMI 可成功区分直径<3mm 的极早期病变与周围正常组织(均 P<0.05),且随着肿瘤直径的增加,灵敏度逐渐降低。此外,归一化强度差(NID)值与微血管密度(MVD)呈良好的线性相关(R=0.75)。另外,当给小鼠注射 MB 后,所有肿瘤在减影超声图像中均无法与周围肌肉区分开来。

结论

总体而言,基于 MB 的 USMI 具有用于早期检测宫颈微小浸润性癌(FIGO 分期 IA1 和 IA2)的巨大临床应用潜力,为该患者人群的影像学筛查的未来研究提供了立足点。

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