Njira yosokoneza ya endoscopy yachipatala mu matenda ophatikizika ndi chithandizo cha zotupa

1, Ukadaulo wotsogola pakuzindikira koyambirira kwa zotupa

(1) Kujambula kwa Molecular Endoscopy

Kusokonezeka kwaukadaulo:

Ma probe opangidwa ndi fulorosenti, monga ma EGFR antibody Cy5.5 markers, amamanga makamaka ku khansa ya m'mimba yoyambirira (sensitivity 92% vs white light endoscopy 58%).

Confocal Laser Microendoscopy (pCLE): Kuwona nthawi yeniyeni ya atypia yama cell pakukula kwa 1000x, ndi kulondola kwa 95% kwa khansa ya m'miyoyo ya Barrett.

Zachipatala:

National Cancer Center yaku Japan idagwiritsa ntchito 5-ALA yochititsa fluorescence kuti azindikire zotupa zam'mimba zam'mimba <1mm.

(2) Nthawi yeniyeni ya AI yothandizira matenda

Kukhazikitsa mwaukadaulo:

Njira zophunzirira mozama monga Cosmo AI zimangolemba ma polyps panthawi ya colonoscopy, zomwe zimapangitsa kuti chiwonjezeko cha 27% cha kuchuluka kwa adenoma (ADR).

Ultrasound endoscopy (EUS) yophatikizidwa ndi AI kusiyanitsa chiopsezo choyipa cha pancreatic cysts (AUC 0.93 vs katswiri 0.82).

2, njira yosinthira ya chithandizo chokhazikika chocheperako

(1) Kusintha kwanzeru kwa endoscopic submucosal dissection (ESD)

Kupambana kwaukadaulo:

Kujambula kwa 3D Optical topology: Dongosolo la Olympus EVIS X1 limawonetsa nthawi yeniyeni ya submucosal vascular course, kuchepetsa magazi ndi 70%.

Nanoknife inathandizira ESD: Irreversible electroporation (IRE) chithandizo cha zilonda zolowera mkati mwa minofu, kusunga umphumphu wakuya.

Zambiri zogwirira ntchito:

(2) Endoscopic ultrasound radiofrequency ablation (EUS-RFA) katatu mankhwala

Kuphatikiza kwaukadaulo:

Ma radiofrequency electrode adalowetsedwa mu singano ya 19G, ndipo khansa ya kapamba idachotsedwa motsogozedwa ndi EUS (kuwongolera kwanuko kunali 73% ≤ 3cm chotupa).

Kuphatikiza mankhwala odzaza nano thovu (monga paclitaxel perfluoropentane) kuti akwaniritse kuphatikiza kwa "mankhwala owonera".

(3) Fluorescence guided lymph node dissection

ICG pafupi ndi infrared kujambula:

Indocyanine wobiriwira anabayidwa maola 24 asanachite opaleshoni, ndipo kufufuza kwa endoscopic kunasonyeza ma lymph nodes mu khansa ya m'mimba (kuchuluka kwa 98%).

Deta yochokera ku Yunivesite ya Tokyo: Kuphatikizika kwa ma lymph node osafunikira kudatsika ndi 40%, ndipo kuchuluka kwa postoperative lymphedema kudatsika kuchoka pa 25% kufika pa 3%.

3, Kuwunika pambuyo pa opaleshoni ndi chenjezo lobwerezabwereza

(1) Liquid Biopsy Endoscopy

Zowunikira zaukadaulo:

Chitani kusanthula kwa ctDNA methylation pa zitsanzo za endoscopic burashi (monga jini ya SEPT9) kuti munenere za chiopsezo choyambiranso (AUC 0.89).

Microfluidic chip Integrated endoscopy: Kuzindikira nthawi yeniyeni ya ma cell chotupa ozungulira (CTCs) m'madzi otsuka m'mimba.

(2) Chojambula chojambula chowoneka bwino

Zaukadaulo:

Magnesium alloy clips adagwiritsidwa ntchito polemba m'mphepete mwa chotupa (monga OTSC Pro), ndipo kuwonongeka kunachitika miyezi 6 pambuyo pa opaleshoni. Kutsata kwa CT sikunawonetse zinthu zakale.

Poyerekeza ndi titaniyamu tatifupi: Kugwirizana kwa MRI kwasintha ndi 100%.

4, Multidisciplinary Joint Innovation Program

(1) Endoscopic laparoscopic hybrid operation (Hybrid NOTE)

Kuphatikiza kwaukadaulo:

Kuchotsa zotupa (monga khansa ya m'matumbo) kudzera mu njira yachilengedwe ya endoscopic, kuphatikiza ndi doko limodzi laparoscopy la lymph node dissection.

Deta yochokera ku Peking University Cancer Center: Nthawi ya opaleshoni idachepetsedwa ndi 35%, kusungidwa kwamatako kudakwera mpaka 92%.

(2) Proton therapy endoscopic navigation

Kukhazikitsa mwaukadaulo:

Kuyika kwa endoscopic kwa ma tag agolide + CT / MRI fusion, kutsata kolondola kwa khansa ya esophageal ndi proton beam (zolakwika <1mm).

5. Mayendedwe aukadaulo amtsogolo

(1) DNA nanorobot endoscope:

"Loboti ya origami" yopangidwa ndi Harvard University imatha kunyamula thrombin kuti isindikize molondola mitsempha yamagazi.

(2) Kusanthula kwanthawi yeniyeni kwa Metabolomics:

Endoscopic Integrated Raman spectroscopy imagwiritsidwa ntchito kuzindikira zala zala za choline (monga choline / creatine ratio) panthawi ya opaleshoni.

(3) Kuneneratu kwa mayankho a Immunotherapy:

PD-L1 fluorescent nanoprobes (gawo loyesera) lolosera mphamvu ya khansa ya m'mimba ya immunotherapy.

Table Yofananira ya Phindu Lachipatala

Malangizo okonzekera njira

Malo owunika khansa yoyambirira: yokhala ndi ma cell fluorescence endoscopy ndi AI yothandizira matenda.

Chipatala chodziwika bwino cha Tumor: Kumanga chipinda cha haibridi cha EUS-RFA.

Kupititsa patsogolo kafukufuku: Kupanga zofufuza zenizeni za chotupa (monga Claudin18.2 yolunjika pa fluorescence).

Ukadaulo uwu ukuyendetsa matenda a chotupa ndi chithandizo munthawi ya "kutsekeka kosalekeza" kudzera m'magawo atatu akuluakulu: kuzindikira kwa mamolekyulu, chithandizo cha millimeter, komanso kuwunika kwamphamvu. Zikuyembekezeka kuti pofika 2030, 70% yamankhwala am'deralo a zotupa zolimba azitsogozedwa ndi endoscopy.