Abstract P3-01-15: Sentinel lymph node biopsy by indocyanine green fluorescence detection in breast cancer cT1-4N0M0 patients. Frequency of false-negative results is low

Breast cancer cT1-4N0M0 patients are usually need in a sentinel lymph node biopsy (SLNB). SLNB by indocyanine green (ICG) fluorescence detection is a modern technique possessing high level of lymph node detection rate, but frequency of false-negative results was not evaluated adequately.

Objective was to determine main diagnostic characteristics of the ICG fluorescence-guided SLNB in BC cT1-4N0M0 patients: node detection rate and frequency of false-negative results.

Methods: 99 patients with 100 cases of breast cancer cT1-4N0M0 (T1 – 43, T2 – 55, T3 – 1, T4 – 1) were operated, axillary part of operation consisted from the ICG fluorescence-guided SLNB and axillary lymphadenectomy of levels I–II or I–II–III. 12 patients had neoadjuvant chemotherapy and 8 – neoadjuvant hormonotherapy. Photodynamic Eye C9830 (Hamamatsu Photonics K.K) was using for emit near infrared radiation and fluorescent image registration. 2 ml 0.25% solution of ICG were injected inra- and sub- cutaneous periareolary or in a tumor projection, 2-5 minutes later it can be see fluorescent way to axillary. The procedure starting from injection of the ICG to the identification of a signal lymph node takes 15–30 minutes.

Results. Transcutaneous fluorescent lymphatic duct was visible in all 100 procedures, but not lymphatic node. Last can be found usually in a wound after Fascia superficialis and Fascia axillaris dissection. A signal lymph node was detected in 98 cases (98 %). Mean amount of sentinel lymphatic nodes = 1.9±0.1 (1-7 nodes). Mean amount of lymphatic nodes took with axillary dissection = 10.5±0.5 (5-26 nodes). In 28 (28.6%) cases of 98 were found to have metastases in signal lymph nodes. Other than signal lymph nodes had metastatic lesion only in 35.7% in signal lymph nodes N+ cases. False negative result occurred in 3 (3.1%) cases of 98, including 2 with metastases in signal lymph node finding by plan histological investigation, but not at froze section. No cases of allergic reactions or other adverse effects were diagnosed with standard subcutaneous use of indocyanine.

Conclusion. Fluorescence technique of the detection of signal lymph nodes has its own methodological issues: in most cases a signal lymph node is not visualized through the skin, it should be visualized in surgical wound using the course of lymphatic duct as guidance. Application of ICG fluorescence-guided SLNB in cN0 breast cancer patients allows high signal lymph node detection rate and low false negative rate, - 3%.

Acknowledgments. The authors thank Professor Gordon C. Wishart for the Sentinel Lymph Node Detection by ICG Fluorescence Technique teaching.

Citation Format: Portnoy SM, Kuznetsov AV, Shakirova NM, Kozlov NA, Maslyaev AV, Karpov AV, Kampova-Polevaya EB, Mistakopulo MG, Egorov YS, Anurova OA, Shendrikova TA, Gornostaeva AS. Sentinel lymph node biopsy by indocyanine green fluorescence detection in breast cancer cT1-4N0M0 patients. Frequency of false-negative results is low [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-01-15.

Silencing AML1-ETO gene expression leads to simultaneous activation of both pro-apoptotic and proliferation signaling

The t(8;21)(q22;q22) rearrangement represents the most common chromosomal translocation in acute myeloid leukemia (AML). It results in a transcript encoding for the fusion protein AML1-ETO (AE) with transcription factor activity. AE is considered to be an attractive target for treating t(8;21) leukemia. However, AE expression alone is insufficient to cause transformation, and thus the potential of such therapy remains unclear. Several genes are deregulated in AML cells, including KIT that encodes a tyrosine kinase receptor. Here, we show that AML cells transduced with short hairpin RNA vector targeting AE mRNAs have a dramatic decrease in growth rate that is caused by induction of apoptosis and deregulation of the cell cycle. A reduction in KIT mRNA levels was also observed in AE-silenced cells, but silencing KIT expression reduced cell growth but did not induce apoptosis. Transcription profiling of cells that escape cell death revealed activation of a number of signaling pathways involved in cell survival and proliferation. In particular, we find that the extracellular signal-regulated kinase 2 (ERK2; also known as mitogen-activated protein kinase 1 (MAPK1)) protein could mediate activation of 23 out of 29 (79%) of these upregulated pathways and thus may be regarded as the key player in establishing the t(8;21)-positive leukemic cells resistant to AE suppression.

[Universal modular system for in vitro screening of potential inhibitors of HIV-1 replication]

Here we describe a system based on recombinant lentiviral vectors for the safe screening of potential anti-HIV drugs. The system allows to evaluate the sensitivity of HIVl-1 reverse transcriptase and integrase (wild-type as well as mutant forms of these enzymes detected in drug-resistant virus isolates) towards different drugs and substances, but also to screen inhibitors of other stages of HIV-1 life cycle.

[Expression of FLT3-ITD oncogene confers mice progenitor B-cells BAF3 sensitivity to the ribonuclease binase cytotoxic action]

Acute myeloid leukemia is the most common acute leukemia affecting adults, and its incidence increases with age. Along with chromosomal translocations in leukemic cells mutations in the genes of receptor tyrosine kinases KIT and FLT3 were found with a high frequency. Here we show that transgenic progenitor of B-cells BAF3/FLT3-ITD are much more sensitive to the ribonuclease binase cytotoxic effects than the original BAF3 cells. The principal difference between BAF3/FLT3-ITD and the original BAF3 cells is the expression of FLT3-ITD oncogene, which leads to a change in the normal cell signaling pathways. Earlier, we described a similar effect for the cytotoxic action of binase on Kasumi-1 and FDC-P1-N822K cells, which express the activated KIT-N822K oncogene. Increased binase cytotoxicity toward the cells, expressing FLT3-ITD oncogene, suggests that, as in the case of FDC-P1 cells, transduced by KIT oncogene, the expression of an activated oncogene determines the sensitivity of cells to binase.