TROP2-targeted NIR-II fluorescence imaging for visualizing surgical margins and metastatic sentinel lymph nodes in breast cancers.
In early breast cancer surgery (EBC), free margins significantly decrease local recurrence in breast-conserving surgery (BCS), while metastatic status of sentinel lymph node (SLN) impacts axillary management. However, intraoperative visualization of margins and metastatic SLNs (mSLNs) remains challenging. Here, we report a second-window near-infrared (NIR-II) fluorescence probe by conjugating ICG to TROP2-targeting cyclic peptide (TTP-ICG). Our results showed that TTP-ICG specifically binds to TROP2-expressing cells in vitro and identifies TROP2-positive tumors in vivo. In addition, TTP-ICG enabled efficient intraoperative evaluation of surgical margins and visualization of mSLNs at a submillimeter level in preclinical models. Additionally, we optimized the rapid incubation imaging method (RIIM) by shortening the procedure to less than 8 min, illustrating TTP-ICG's high performance in distinguishing malignant from normal tissues/fibroadenoma lesions as well as detecting metastatic lymph nodes in a cohort of 59 patients. Thus, this TROP2-targeting probe demonstrates its significance for fluorescence imaging-guided surgery with dual applicability in EBC, providing translational potential for further clinical decision-making.
Authors
Lou Lou, Bai Bai, Liu Liu, Lin Lin, Li Li, Gao Gao, Lin Lin, Pei Pei, Wei Wei, Chen Chen, Tang Tang, Chen Chen, Li Li, Guo Guo, Tang Tang, Wu Wu, Zhang Zhang
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