Volume 114, Issue 8 pp. 951-958
Research Article

Effective fluorescence-guided surgery of liver metastasis using a fluorescent anti-CEA antibody

Yukihiko Hiroshima MD, PhD

Yukihiko Hiroshima MD, PhD

Department of Surgery, University of California San Diego, San Diego, California

AntiCancer, Inc., San Diego, California

Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

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Thinzar M. Lwin MD

Thinzar M. Lwin MD

Department of Surgery, University of California San Diego, San Diego, California

AntiCancer, Inc., San Diego, California

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Takashi Murakami MD

Takashi Murakami MD

Department of Surgery, University of California San Diego, San Diego, California

AntiCancer, Inc., San Diego, California

Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

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Ali A. Mawy MD

Ali A. Mawy MD

Department of Surgery, University of California San Diego, San Diego, California

AntiCancer, Inc., San Diego, California

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Tanaka Kuniya MD, PhD

Tanaka Kuniya MD, PhD

Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

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Takashi Chishima MD, PhD

Takashi Chishima MD, PhD

Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

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Itaru Endo MD, PhD

Itaru Endo MD, PhD

Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

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Bryan M. Clary MD

Bryan M. Clary MD

Department of Surgery, University of California San Diego, San Diego, California

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Robert M. Hoffman PhD

Robert M. Hoffman PhD

Department of Surgery, University of California San Diego, San Diego, California

AntiCancer, Inc., San Diego, California

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Michael Bouvet MD

Corresponding Author

Michael Bouvet MD

Department of Surgery, University of California San Diego, San Diego, California

Correspondence to: Michael Bouvet, MD, Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive #0987, La Jolla, CA 92093-0987. Fax: +1-858-822-6192. E-mail: [email protected]

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First published: 03 October 2016
Citations: 27
Conflict of interest: The authors have no conflicts of interest to disclose.

Abstract

Background and Objectives

Delineation of adequate tumor margins is critical in oncologic surgery, particularly in resection of metastatic lesions. Surgeons are limited in visualization with bright-light surgery, but fluorescence-guided surgery (FGS) has been efficacious in helping the surgeon achieve negative margins.

Methods

The present study uses FGS in a mouse model that has undergone surgical orthotopic implantation (SOI) of colorectal liver metastasis tagged with green fluorescent protein (GFP). An anti-CEA antibody conjugated to DyLight 650 was used to highlight the tumor.

Results

The fluorescent antibody clearly demarcated the lesion at deeper tissue depth compared to GFP. Fluorescence of the anti-CEA-DyLight650 showed maximal tumor-to-liver contrast at 72 hr. Fifteen mice underwent bright-light surgery (BLS) versus FGS with GFP versus FGS with anti-CEA-DyLight650. Mice that underwent FGS had a significantly smaller area of residual tumor (P < 0.001) and significantly longer overall survival (P < 0.001) and disease-free survival (P < 0.001). Within the two FGS groups, mice undergoing surgery with anti-CEA-DyLight650 improved survival compared to only GFP labeling.

Conclusions

In the present report, we demonstrate that an anti-CEA antibody conjugated to a DyLight 650 nm dye clearly labeled colon cancer liver metastases, thereby enabling successful FGS. J. Surg. Oncol. 2016;114:951–958. © 2016 Wiley Periodicals, Inc.

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