癌の外科手術における磁気応用－センチネルリンパ節マッピングと術中迅速診断－

カテゴリ: 論文誌(論文単位)

グループ名: 【A】基礎・材料・共通部門

発行日: 2022/06/01

タイトル(英語): Application of Magnetic Nanoparticle in Cancer Surgery―Sentinel Node Mapping and Magnetically Promoted Rapid Immunofluorescence Staining―

著者名: 三原　規奨（川崎市立川崎病院外科），大西　達也（国立がん研究センター東病院乳腺外科），松田　祐子（慶應義塾大学医学部一般・消化器外科），坂本　聡（東京工業大学生命理工学院），半田　宏（東京医科大学ナノ粒子先端医学応用講座），桑波田　晃弘（東北大学大学院工学研究科），関野　正樹（東京大学大学院工学系研究科），日下部　守昭（東京大学大学院農学生命科学研究科食の安全研究センター），北川　雄光（慶應義塾大学医学部一般・消化器外科）

著者名(英語): Kisyo Mihara (Department of Surgery, Kawasaki Municipal Kawasaki Hospital), Tatsuya Onishi (Department of Breast Surgery, National Cancer Center Hospital East), Sachiko Matsuda (Department of Surgery, Keio University School of Medicine), Satoshi Sakamoto (School of Life Science and Technology, Tokyo Institute of Technology), Hiroshi Handa (Department of Nanoparticle Translational Research, Tokyo Medical University), Akihiro Kuwahata (Graduate School of Engineering, Tohoku University), Masaki Sekino (Graduate School of Engineering, The University of Tokyo), Moriaki Kusakabe (Graduate School of Agricultural and Life Sciences, Research Center for Food Safety, The University of Tokyo), Yuko Kitagawa (Department of Surgery, Keio University School of Medicine)

キーワード: センチネルリンパ節，腹腔鏡手術，迅速免疫染色，磁気応用　　sentinel lymph node (SLN)，laparoscopic surgery，rapid immunostaining，application of magnetic field

要約(英語): Recently, there has been remarkable progress in the field of magnetic nanoparticles, with them now being applied in cancer surgery. During tumor surgery, lymph node dissection is required along with tumor resection. However, in cases such as breast cancer, lymph node dissection can be omitted if no metastasis is found in the sentinel lymph node (SLN; the first draining lymph node from a primary tumor), thereby reducing postoperative sequelae. The presence or absence of SN metastasis alters the surgical procedure; therefore, intraoperative SLN mapping and rapid pathological SLN diagnosis are required. The standard procedure of SLN mapping is a combination of radioisotope and dye methods, but radioisotope methods have problems associated with regulation and safety. To overcome these problems, a SLN mapping method using magnetic nanoparticles has been developed. This technique has already been clinically applied to breast cancer. In this article, a laparoscopic magnetic probe was developed to expand the SLN theory to visceral organs such as the stomach and gallbladder. A preclinical study of SLN mapping was feasible in laparoscopic minimally invasive surgery. Although resected sentinel lymph nodes can be rapidly diagnosed intraoperatively, the diagnostic accuracy of hematoxylin and eosin staining is limited. Conversely, immunohistochemistry, which gives additional information to pathologists by staining particular proteins, has not yet been used for rapid diagnostics because of the time required for staining. A new rapid immunostaining method is magnetically-promoted rapid immunofluorescence staining using functionalized fluorescent ferrite beads. The antigen-antibody reaction is accelerated by magnetic force, and antigen-antibody complexes can be directly observed with a fluorescence microscope. We have succeeded in diagnosing frozen sections within 15 min from fixation to staining. To realize minimally invasive surgery, a detailed understanding of tumor development is essential, and nanotechnology is being applied in this field to address this issue. In this paper, we introduce a SLN biopsy and rapid immunostaining method based on magnetic nanoparticle technology to further this field.

本誌: 電気学会論文誌A（基礎・材料・共通部門誌） Vol.142 No.6 （2022） 特集：バイオ・医療における磁界・磁性材料の応用研究と産学官連携

本誌掲載ページ: 236-242 p

原稿種別: 解説論文／日本語

電子版へのリンク: https://www.jstage.jst.go.jp/article/ieejfms/142/6/142_236/_article/-char/ja/