Auto fluorescence findings of lung cancer specimens indicate invasiveness and prognosis

• Project/Area Number: 16K10683
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Respiratory surgery
• Research Institution: The University of Tokushima
• Principal Investigator: TAKIZAWA Hiromitsu 徳島大学, 大学院医歯薬学研究部(医学域), 准教授 (90332816)
• Co-Investigator(Kenkyū-buntansha): 近藤 和也 徳島大学, 大学院医歯薬学研究部(医学域), 教授 (10263815) ; 梶浦 耕一郎 徳島大学, 大学院医歯薬学研究部(医学系), 助教 (60596253) ; 坪井 光弘 徳島大学, 病院, 助教 (10711872) ; 澤田 徹 徳島大学, 病院, 特任助教 (60522258)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000); Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2017: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2016: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
• Keywords: 肺癌 / 自家蛍光 / 胸膜浸潤 / 縮小手術

Outline of Final Research Achievements

Fluorescence microscopy (excitation wavelength 470 ± 40 nm, absorption wavelength 525 ± 50 nm) visualizes elastic fibers that are the skeletal structure of lung tissue as a green network. Structural changes in the elastic fiber network, such as disruption, rupture, and disappearance, are observed in the infiltrated areas of lung adenocarcinoma. When lung cancer tissues were diagnosed as invasive cancers using fluorescence microscopy, they included pathological infiltrates such as pleural, vascular, and lymphatic infiltrates. Such invasive cases had a higher risk of postoperative recurrence than cases diagnosed as non-invasive. Fluorescence findings can also be observed in unstained frozen sections, which can be applied for rapid intraoperative diagnosis and may help in the selection of surgical treatment for lung cancer.

Academic Significance and Societal Importance of the Research Achievements

肺がん手術において，適切な切除範囲を決定することはとても重要である．近年，小型肺がんがよく発見されるようになったが，不用意に切除範囲を縮小すると，肺は温存できてもがん再発のリスクが高くなる．本研究では，術中に採取した肺がん組織を蛍光顕微鏡で観察することで，がんの浸潤程度や再発リスクを把握し，その結果を切除範囲に反映できるか検討した．蛍光顕微鏡で肺がん組織を観察すると，正常部や非浸潤部に認められる緑色の規則正しい網目構造が，浸潤部（悪性度が高い部分）では破壊されている様子が観察され，そのような浸潤部がある肺がん患者は術後再発リスクが高いことが明らかになった．

Research Products

• [Journal Article] Autofluorescence for the diagnosis of visceral pleural invasion in non-small-cell lung cancer. (2018)
  • Author(s): Takizawa H, Kondo K, Kawakita N, Tsuboi M, Toba H, Kajiura K, Kawakami Y, Sakiyama S, Tangoku A, Morishita A, Nakagawa Y, Hirose T.
  • Journal Title: Eur J Cardiothorac Surg Volume: 53 Issue: 5 Pages: 987-992
  • DOI: 10.1093/ejcts/ezx419
  • Peer Reviewed
• [Presentation] 蛍光顕微鏡を用いた肺腺癌浸潤診断についての検討 (2019)
  • Author(s): 滝沢 宏光、竹原 恵美、宮本 直輝、高嶋 美佳、松本 大資、河北 直也、坪井 光弘、鳥羽 博明、吉田 光輝、川上 行奎、近藤 和也、丹黒 章
  • Organizer: 第60回日本肺癌学会学術集会