Lymph node (LN) metastasis is thought to account for 20‐30% of deaths from head and neck cancer. The lymphatic drug delivery system (LDDS) is a new technology that enables the injection of drugs into a sentinel LN (SLN) during the early stage of tumor metastasis to treat the SLN and secondary metastatic LNs. However, the optimal physicochemical properties of the solvent used to carry the drug have not been determined. Here, we show that the osmotic pressure and viscosity of the solvent influenced the antitumor effect of cisplatin (CDDP) in a mouse model of LN metastasis. Tumor cells were inoculated into the proper axillary LN (PALN), and the LDDS was used to inject CDDP solution into the subiliac LN (SiLN) to treat the tumor cells in the downstream PALN. CDDP dissolved in saline had no therapeutic effects in the PALN after it was injected into the SiLN using the LDDS or into the tail vein (as a control). However, CDDP solution with an osmotic pressure of ~ 1,900 kPa and a viscosity of ~ 12 mPa⋅s suppressed tumor growth in the PALN after it was injected into the SiLN using the LDDS. The high osmotic pressure dilated the lymphatic vessels and sinuses to enhance drug flow in the PALN, and the high viscosity increased the retention of CDDP in the PALN. Our results demonstrate that optimizing the osmotic pressure and viscosity of the solvent can enhance the effects of CDDP, and possibly other anticancer drugs, after administration using the LDDS.
Metastatic lymph nodes (
LN
s) may be the origin of systemic metastases. It will be important to develop a strategy that prevents systemic metastasis by treating these
LN
s at an early stage. False‐negative metastatic
LN
s, which are found during the early stage of metastasis development, are those that contain tumor cells but have a size and shape similar to
LN
s that do not host tumor cells. Here, we show that 5‐fluorouracil (5‐
FU
), delivered by means of a novel lymphatic drug delivery system (
LDDS
), can treat
LN
s with false‐negative metastases in a mouse model. The effects of 5‐
FU
on four cell lines were investigated using in vitro cytotoxicity and cell survival assays. The therapeutic effects of
LDDS
‐administered 5‐
FU
on false‐negative metastatic
LN
s were evaluated using bioluminescence imaging, high‐frequency ultrasound (
US
), and histology in
MHX
10/Mo‐
lpr
/
lpr
mice. These experimental animals develop
LN
s that are similar in size to human
LN
s. We found that all cell lines showed sensitivity to 5‐
FU
in the in vitro assays. Furthermore, a concentration‐dependent effect of 5‐
FU
to inhibit tumor growth was observed in tumor cells with low invasive growth characteristics, although a significant reduction in metastatic
LN
volume was not detected in
MHX
10/Mo‐
lpr
/
lpr
mice. Adverse effects of 5‐
FU
were not detected. 5‐Fluorouracil administration with a
LDDS
is an effective treatment method for false‐negative metastatic
LN
s. We anticipate that the delivery of anticancer drugs by a
LDDS
will be of great benefit in the prevention and treatment of cancer metastasis via
LN
s.
Treatment of metastatic lymph nodes (LNs) is challenging due to their unique architecture and biophysical traits. Systemic chemotherapy fails to impede tumor progression in LNs due to poor drug uptake and retention by LNs, resulting in fatal systemic metastasis. To effectively treat LN metastasis, achieving specific and prolonged retention of chemotherapy drugs in the tumor‐draining LNs is essential. The lymphatic drug‐delivery system (LDDS) is an ultrasound‐guided drug‐delivery methodology for administration of drugs to LNs that addresses these requirements. However, early‐stage metastatic LNs have an additional set of drug transport barriers, such as elevated intranodal pressure and viscosity, that negatively impact drug diffusion. In the present study, using formulations of elevated osmotic pressure and viscosity relative to saline, we sought to favorably alter the LN's physical environment and study its impact on pharmacokinetics and consequently the therapeutic efficacy of carboplatin delivered using the LDDS. Our study confirmed the capability of a drug formulation with elevated osmotic pressure and viscosity to alter the architecture of LNs, as it caused notable expansion of the lymphatic sinus. Additionally, the study delineated an optimal range of osmotic pressure and viscosity, centered around 1897 kPa and 11.5 mPa·s, above and below which therapeutic efficacy was found to decline markedly. These findings suggest that formulation osmotic pressure and viscosity are parameters that require critical consideration as they can both hinder and promote tumorigenesis. The facile formulation reported here has wide‐ranging applicability across cancer spectrums and is thus anticipated to be of great clinical benefit.
We studied tumour lymphangiogenesis and lymphatic invasion using D2-40 endothelial marker in 35 breast cancer patients treated by primary surgery and correlated it with various clinico-pathological prognostic parameters. Lymphangiogenesis was quantified using lymphatic micro vessel density (LMVD) by counting the immunostained lymphatic microvessels at 200×. The mean age was 45.97 ± 12.09 years (range 30-80 years). LMVD ranged from 5/hpf to 56/hpf with a mean score of 13.4 ± 10.8 and median of 9. The median value of 9 was taken to classify patients into a low or high LMVD. LMVD correlated significantly with tumour size (p = 0.003), histological grade (p = 0.046), lymph node status (p = 0.030). There was no significant correlation of LMVD with stage, estrogen receptor, progesterone receptor or HER2/neu immunoreactivity. Lymphovascular invasion on D2-40 staining [LVI-D40] was found in 13 (37.1%) cases compared to 6 cases (17.1%) on H & E staining showing a poor agreement (k = 0.244). LVI correlated significantly with lymph node status (p = 0.011). There was a strong association between tumour size (p = 0.142), histological grade (p = 0.066) though the correlation was not statistically significant. No correlation was found with stage, estrogen receptor, progesterone receptor or HER2/neu immunoreactivity. The mean LMVD in LVI positive patients was higher (22.85 ± 13.29) as compared to LVI negative patients (7.95 ± 2.05) and this was statistically significant (p = 0.001). Increased D2-40 detected LMVD and LVI correlated with poor prognostic parameters.
A comparative study between professional and amateur medium-fast bowlers was conducted to assess the difference between the standing broad jump Performance of both groups. 40 male participants of the age group 16-19 were selected for the study. SBJ (standing broad jump) was considered the dependent variable. The health status and subjects' willingness to participate in the study was considered prior to the test. For the calculations, independent samples t-test was used with a 0.05 level of significance. Data were computed with the help of IBM SPSS 26 software. The mean performance of professional mediumfast bowlers was found to be 2.26 whereas it was 2.16 for the amateur medium-fast bowlers. On the 0.05 level of significance, the null hypothesis failed to be rejected at obtained t-value = -0.458. It was concluded that there was no statistically significant difference between both groups. Further recommendations were made for future studies.
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