Effective fluorescence-guided surgery of liver metastasis using a fluorescent anti-CEA antibody
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
Search for more papers by this authorThinzar M. Lwin MD
Department of Surgery, University of California San Diego, San Diego, California
AntiCancer, Inc., San Diego, California
Search for more papers by this authorTakashi 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
Search for more papers by this authorAli A. Mawy MD
Department of Surgery, University of California San Diego, San Diego, California
AntiCancer, Inc., San Diego, California
Search for more papers by this authorTanaka Kuniya MD, PhD
Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
Search for more papers by this authorTakashi Chishima MD, PhD
Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
Search for more papers by this authorItaru Endo MD, PhD
Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
Search for more papers by this authorBryan M. Clary MD
Department of Surgery, University of California San Diego, San Diego, California
Search for more papers by this authorRobert M. Hoffman PhD
Department of Surgery, University of California San Diego, San Diego, California
AntiCancer, Inc., San Diego, California
Search for more papers by this authorCorresponding 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]
Search for more papers by this authorYukihiko 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
Search for more papers by this authorThinzar M. Lwin MD
Department of Surgery, University of California San Diego, San Diego, California
AntiCancer, Inc., San Diego, California
Search for more papers by this authorTakashi 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
Search for more papers by this authorAli A. Mawy MD
Department of Surgery, University of California San Diego, San Diego, California
AntiCancer, Inc., San Diego, California
Search for more papers by this authorTanaka Kuniya MD, PhD
Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
Search for more papers by this authorTakashi Chishima MD, PhD
Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
Search for more papers by this authorItaru Endo MD, PhD
Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
Search for more papers by this authorBryan M. Clary MD
Department of Surgery, University of California San Diego, San Diego, California
Search for more papers by this authorRobert M. Hoffman PhD
Department of Surgery, University of California San Diego, San Diego, California
AntiCancer, Inc., San Diego, California
Search for more papers by this authorCorresponding 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]
Search for more papers by this authorAbstract
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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