Fine needle aspiration biopsy proves increased T-lymphocyte proliferation in tumor and decreased metastatic infiltration after treatment with doxorubicin bound to PHPMA copolymer carrier

Repeated fine-needle aspiration of solid tumours in mice allows the identification of multiple infiltrating immune cell types

This paper describes a novel method for following the changes in mouse tumour-infiltrating immune cell populations by repeated sampling of tumours by fine needle aspiration (FNA), followed by flow cytometry. Using this technique we were able to collect samples from P815 mouse mastocytomas, and identify and enumerate six tumour-infiltrating immune cell types at multiple time points for each mouse. We demonstrate good agreement between cell percentages obtained from FNA samples and matched whole tumour digests (WTDs). We also demonstrate that neither survival nor the incidence of liver metastasis is adversely affected by the procedure. Our method has a clear advantage over the common practice of sacrificing mice and collecting tissue at pre-determined time points, as the technique allows 1) repeated sampling of each mouse over time, thus many fewer mice are required, and 2) the correlation of survival data with tumour-infiltrating immune cell types at different time points. This potentially allows immune cell types associated with increased or decreased survival to be identified. Therefore, our technique should greatly facilitate the characterisation of anti-tumour immunity induced in response to cancer therapy in small animal models.

A new strategy for the surgical management of RLN infiltrated by well-differentiated thyroid carcinoma

Well-differentiated thyroid carcinoma (WDTC) represents the most common endocrine malignancy. Despite excellent prognoses exceeding 90% in 10-year follow-up, there are clinically controversial issues. One of these is extrathyroidal tumour extension invading recurrent laryngeal nerve (RLN). The spread outside of the thyroid parenchyma and invasion to the surrounding structures, classified as always T4a, are the most important negative prognostic factor for the WDTC. Conversely, resection of the RLN leads to vocal cord paralysis with hoarseness, possible swallowing problems, and finally decreased quality of life. We propose a new algorithm for intraoperative management based on the MACIS classification, which would allow swift status evaluation pre/intraoperatively and consider a possibility to preserve the infiltrated RLN without compromising an oncological radicality. In the case of a preoperative vocal cord paralysis (VCP) and confirmation of the invasive carcinoma, a resection of the RLN and the nerve graft reconstruction are indicated. Preoperatively, unaffected vocal cord movement and intraoperatively detected RLN infiltration by the invasive WDTC require an individual assessment of the oncological risk by the proposed algorithm. Preservation of the infiltrated RLN is oncologically acceptable only in specific groups of patients of a younger age with a minor size of primary tumour.