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Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition) ›› 2023, Vol. 10 ›› Issue (04): 253-257. doi: 10.3877/cma.j.issn.2095-7157.2023.04.004

• Original Articles • Previous Articles     Next Articles

A preliminary exploratory study of the impact of 68Ga-NC-BCH combined with PET-CT lymph node immune tracer techniques on preoperative and postoperative clinical decision-making for gastric cancer patients

Jiafeng Wang, Rui Guo, Qianqian Chen, Huikai Li, Bo Ning, Xinpu Yuan, Hua Zhu(), Enqiang Linghu()   

  1. Medical School of Chinese PLA, Beijing 100853, China; Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing 100853, China
    Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing 100142, China
    Department of Gastroenterology, The First Medical Center of PLA General Hospital, Beijing 100853, China
    Senior Department of General Surgery, the First Medical Center of Chinese PLA General Hospital, Beijing, China
  • Received:2023-10-05 Online:2023-11-15 Published:2023-11-09
  • Contact: Hua Zhu, Enqiang Linghu

Abstract:

Objective

Laparoscopic/robotic radical resection and super minimally invasive surgery(SMIS)are currently the main surgical methods for the treatment of gastric cancer.However, there are the following issues in clinical decision-making before and after surgery: (1)There is still a lack of effective means for accurately determining the scope of lymph node dissection in laparoscopic/robotic radical resection surgery; (2)There are still difficulties in accurately determining the presence of lymph node metastasis around the stomach after non-curative resection of super minimally invasive surgery.Currently, the use of the antigen-specific imaging agent 68Ga-NC-BCH in combination with positron emission tomography-computed tomography (PET/CT) has shown promising results in guiding Chimeric Antigen Receptor T-Cell Immunotherapy (CART) treatment for gastric cancer patients. However, there is no relevant research on whether it can be combined with lymph node immune tracing to guide preoperative and postoperative clinical decisions for gastric cancer patients.Therefore, this study aims to explore the impact of 68Ga-NC-BCH combined with PET-CT lymph node immune tracing on preoperative and postoperative clinical decisions for gastric cancer patients.

Methods

From April to September 2023, five cases of advanced gastric cancer patients who received treatment at the First Medical Center of PLA General Hospital were selected. Prior to surgery, abdominal CT scans and 68Ga-NC-BCH combined PET-CT lymph node immune tracing were performed, followed by laparoscopic/robotic gastric cancer resection and extended lymph node dissection.

Result

Among the 5 cases, preoperative CT scans indicated enlarged gastric lymph nodes in 3 cases (60%). However, lymph node immunostaining using 68Ga-NC-BCH combined with PET-CT did not reveal any abnormalities. Postoperative pathological examination of the enlarged lymph nodes confirmed the absence of cancer tissue in all 3 cases.The results of preoperative lymph node immunostaining using 68Ga-NC-BCH combined with PET-CT were consistent with postoperative pathological examination results in all 5 cases (100%). These preliminary findings suggest that compared to CT, lymph node immunostaining using 68Ga-NC-BCH combined with PET-CT has higher accuracy in determining gastric lymph node metastasis in patients with gastric cancer.

Conclusion

This study preliminarily confirmed the feasibility and safety of using 68Ga-NC-BCH combined with PET-CT lymph node immune tracing to guide preoperative and postoperative clinical decisions for gastric cancer patients. However, further prospective studies with larger sample sizes are needed to confirm the above conclusion.

Key words: 68Ga-NC-BCH, PET-CT, Lymph node immune tracing, Gastric cancer, Clinical decision-making

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