Martinelli Serena, Fortuna Laura, Coratti Francesco, Passagnoli Federico, Amedei Amedeo, Cianchi Fabio
Department of Clinical and Experimental Medicine, University of Florence, 50139 Florence, Italy.
Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), 50134 Florence, Italy.
Cancers (Basel). 2024 Dec 12;16(24):4141. doi: 10.3390/cancers16244141.
Gastric cancer (GC) is a malignant tumor of the gastrointestinal tract associated with high mortality rates and accounting for approximately 1 million new cases diagnosed annually. Surgery, particularly radical gastrectomy, remains the primary treatment; however, there are currently no specific approaches to better distinguish malignant from healthy tissue or to differentiate between metastatic and non-metastatic lymph nodes. As a result, surgeons have to remove all lymph nodes indiscriminately, increasing intraoperative risks for patients and prolonging hospital stay. Near-infrared fluorescence imaging with indocyanine green (ICG) can provide real-time visualization of the surgical field using both conventional laparoscopy and robotic mini-invasive precision surgery platforms. However, its application shows some limits, as ICG is a non-targeted contrast agent. Several studies are now investigating the potential efficacy of fluorescent targeted agents that could selectively bind to the tumor tissue, offering a valuable tool for metastatic mapping during robotic gastrectomy. This review aims to summarize the key fluorescent agents that have been developed to recognize GC markers, as well as those targeting the tumor microenvironment (TME) and metabolic features. These agents hold great potential as valuable tools for enhancing precision surgery in robotic gastrectomy procedures improving the clinical recovery of GC patients.
胃癌（GC）是一种胃肠道恶性肿瘤，死亡率很高，每年新诊断病例约100万例。手术，尤其是根治性胃切除术，仍然是主要的治疗方法；然而，目前尚无更好地区分恶性组织与健康组织或区分转移性和非转移性淋巴结的具体方法。因此，外科医生不得不盲目地切除所有淋巴结，增加了患者的术中风险并延长了住院时间。使用吲哚菁绿（ICG）的近红外荧光成像可以通过传统腹腔镜和机器人微创精准手术平台提供手术视野的实时可视化。然而，其应用存在一些局限性，因为ICG是一种非靶向造影剂。目前有几项研究正在调查荧光靶向剂的潜在疗效，这些靶向剂可以选择性地与肿瘤组织结合，为机器人胃切除术中的转移灶定位提供有价值的工具。本综述旨在总结已开发的用于识别GC标志物以及靶向肿瘤微环境（TME）和代谢特征的关键荧光剂。这些试剂作为增强机器人胃切除手术精准度、改善GC患者临床恢复的有价值工具具有巨大潜力。
