Selective Adsorption and Separation of (−)-Epigallocatechin Gallate (EGCG) based on Silica Gel Surface Molecularly Imprinted Polymers

AbstractTo separate and enrich EGCG from a mixture of tea catechins, the molecular imprinted polymers (MIPs) were synthesized on silica gel by surface molecular imprinting technique and characterized with Fourier transform infrared spectroscopy (FT-IR), elemental analysis and scanning electronic microscopy (SEM). MIPs exhibited favorable recognition, better selectivity for EGCG than the other monomers, and the descending order was EGCG, (+)-catechin (C), (−)-epicatechin (EC), (−)-epigallocatechin (EGC), (−)-catechin gallate (CG) and (−)-gallocatechin gallate (GCG). These results demonstrated that MIPs could realize the separation and enrichment of EGCG in real sample

Research progress of axillary de-escalation management after neoadjuvant chemotherapy for clinical lymph node positive patients

In the era of effective systemic therapy and precise radiotherapy, neoadjuvant treatment (NAT) for breast cancer can de-escalate breast cancer treatment to conserve breast and spare axillary lymph node dissection (ALND). At present, high axillary nodal pathologic complete response (apCR) is achieved in patients with human epidermal growth factor receptor 2 (HER2)-positive and triple-negative breast cancer (TNBC), and it is hopeful to realize the axillary de-escalation management. It is recommended that sentinel lymph node (SLN) biopsy (SLNB) is a feasible alternative to ALND in primary clinical lymph node negative (cN0) patients, and the presence of lower residual tumor burden in SLN after NAT may be considered as a replacement for ALND with radiotherapy. The feasibility of the patients with initial clinical lymph node positive (cN+) turning to conventional SLNB after NAT is still being questioned. The main obstacle is the high false negative rate of SLNB after NAT, residual tumor cells in the axilla cannot be accurately predicted, and the risk of postoperative axillary recurrence and metastasis cannot be determined. The false negative rate of SLNB may meet the clinical requirement under the condition of combined tracing, more than 3 SLNs detected, and lower clinical axillary metastatic tumor burden. However, the quality of SLNB after NAT cannot be effectively improved due to tumor cells blocking lymphatic vessels and affecting the drainage of blue dye or radionuclide. Therefore, optimization of SLNB technology needs to be implemented after NAT. Targeted axillary lymph node dissection (TAD) is a precise surgical procedure for the detection of metastatic axillary lymph nodes, and clips were placed on the metastatic lymph nodes before NAT and targeted to detect the lymph nodes after NAT. It can further reduce the false negative rate of SLNB after NAT and improve the accurate assessment of residual tumor burden in axillary lymph nodes after NAT. TAD is expected to be a safe and reliable axillary staging technique for breast cancer patients after NAT. This article reviewed the de-escalation treatment of NAT in initial cN+ patients and the research progress of TAD

Internal mammary sentinel lymph node biopsy for breast cancer: a long-term follow-up research for assessment of prognosis and guiding individualized internal mammary lymph node irradiation

Background and purpose: Internal mammary lymph node irradiation (IMNI) improves survival in patients with internal mammary lymph node (IMLN) high-risk metastatic breast cancer. The purpose of this study was to study the advantages of internal mammary sentinel lymph node (IMLN) biopsy (IM-SLNB) for assessing prognosis and directing individualized IMNI. Methods: This study evaluated patients recruited in three prospective clinical trials (NCT01642511, NCT03541278, and NCT03024463) from November 2011 to December 2021, assessed for prognostic risk variables based on IMSLN metastatic status and prognosis between subgroups. In patients who received regional lymph node irradiation, the implementation status, survival benefit, and influence of IMNI on radiation-induced lung injury (RILI) were studied. The primary endpoint was disease-free survival (DFS), with overall survival (OS) and RILI as secondary endpoints. Results: The study enrolled 537 patients and had a 60-month median follow-up. Patients with IMSLN metastasis had a significantly worse 5-year DFS and OS (DFS: 95.1% vs 71.4%, OS: 99.1% vs 90.1%, both P<0.05), and IMSLN metastatic status was an independent risk factor for DFS and OS (both P<0.05). Adding IMNI did not improve DFS (P = 0.099) or OS (P = 0.486) in patients with negative IMSLN, while it did increase the risk of RILI (OR = 3.678, P<0.05). However, adding IMNI improved 5-year DFS (87.3% vs 52.5%, P = 0.040) for patients with positive IMSLN but had no effect on OS (P = 0.603). Conclusion: This study discovered that IMSLN metastatic status has significant prognostic importance. Patients with IMSLN metastasis who receive IMNI have significantly improved prognosis, and patients without IMSLN metastasis have a much lower risk of RILI by being exempt from IMNI without worse prognosis

Radiotracer technique optimization for breast cancer internal mammary sentinel lymph node biopsy

Background and purpose: The modified injection technique developed in Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences has significantly improved the visualization rate of internal mammary sentinel lymph nodes (IMSLN), however there is still a gap between the visualization rate of IMSLN obtained by this technique and that of axillary sentinel lymph nodes (ASLN). The study aimed to further improve the IMSLN visualization rate and promote the widespread use of internal mammary sentinel lymph node biopsy (IM-SLNB) by optimizing the modified injection technique. Methods: A total of 159 patients with primary breast cancer were enrolled in a prospective group and divided into the optimized radiotracer technique group (group A, n=81) and the modified injection technique group (group B, n=78). In group A, 99mTc-sulfur colloid was injected averagely into parenchyma in the gland's three most abundant regions under ultrasound guidance (total radioactive intensity 1.0-1.3 mCi; 0.8-1.0 mL/point). In group B, 99mTc-sulfur colloid was injected averagely into the parenchyma of the breast at 6 and 12 points under ultrasound guidance (total radioactive intensity 1.0-1.3 mCi; 0.8-1.0 mL/point). Single photon emission computed tomography (SPECT)/computed tomography (CT) lymphoscintigraphy was performed preoperatively, and the sentinel lymph nodes were detected intraoperatively by γ probe. In this study, we evaluated the differences in IMSLN and ASLN visualization rates between the groups, and also analyzed the factors that may affect the IMSLN visualization rate. Results: There was no statistically significant difference in visualization rate of IM-SLN measured by preoperative SPECT/CT between the two groups (P=0.806). The intraoperative visualization rate of IM-SLN was significantly higher in group A than in group B (87.65% vs 70.51%, P=0.008). Analysis of subgroups showed that the intraoperative visualization rate of IMSLN was 92.31% and 83.33% (P=0.315) in group A patients aged ≤50 years and >50 years, respectively, and the intraoperative visualization rate of IMSLN was significantly higher in group B patients aged ≤50 years than in patients aged >50 years (81.58% vs 60.00%, P=0.037). The median in vitro radioactivity count of IMSLN was significantly higher in group A than in group B (160.50 vs 59.00, P=0.005). Conclusion: The optimized radiotracer technique can effectively increase the lymphatic drainage and uptake in the internal mammary region of the radiotracer, which can significantly improve the visualization rate of IM-SLN without affecting the visualization rate of ASLN, and is conducive to the promotion and application of IM-SLNB