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Organoide zur Weiterentwicklung der intraoperativen Diagnostik

Organoids for the advancement of intraoperative diagnostic procedures

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Zusammenfassung

Im Rahmen von onkologischen Operationen besteht immer die Abwägung zwischen onkologischer Sicherheit und dem Funktionserhalt. Dies gilt insbesondere bei Operationen im Becken, aufgrund der engen Lagebeziehung zur Muskulatur des Beckenbodens sowie Gefäß und Nervenverläufen. Aktuell dienen zumeist Risikomodelle, präoperative Bildgebung, die Einschätzung des Operateurs sowie der intraoperative Schnellschnitt als Entscheidungsgrundlage. Neue Bildgebungstechniken sowie Standardisierung im Schnellschnitt haben diese in den letzten Jahren deutlich verbessert. Es verbleiben jedoch weiterhin Einschränkungen durch zeitliche Verzögerung sowie erschwerte korrekte anatomische Zuordnung der zu untersuchenden Präparate. Alternative intraoperative Verfahren könnten diese Grenzen in der Zukunft überwinden. Patientenabgeleitete Organoide haben sich in den letzten Jahren zu einem wichtigen neuen Forschungsvehikel entwickelt. Sie basieren auf Tumorstammzellen, die unter speziellen Kulturbedingungen dreidimensionale Replikate des Ursprungsgewebes formen. Damit sind sie optimal geeignet zur Testung von individuellen Systemtherapien aber auch als Validierungstechnik für neue diagnostische Verfahren. Das durch die Deutsche Forschungsgemeinschaft geförderte Graduiertenkolleg 2543/I analysiert in einem interdisziplinären Team das Potenzial neuer diagnostischer Methoden im Hinblick auf die intraoperative real-time Diagnostik in Ergänzung zu konventionellen Schnellschnittdiagnostik

Abstract

In the context of cancer surgery, there is always a trade-off between oncological safety and preservation of function. This is especially true in pelvic surgery due to the close relationship to the pelvic floor muscles, blood supply and nerves. Currently, risk models, preoperative imaging, the surgeon’s assessment, and the intraoperative frozen section serve as the basis for decision-making. New imaging techniques and standardization in frozen section have significantly improved this in recent years. However, limitations remain due to time delays as well as more difficult correct anatomical assignment in the follow-up. Alternative intraoperative techniques may overcome this limitation in the future. Patient-derived organoids have emerged as an important new research vehicle in recent years. They are based on tumor stem cells that, under special culture conditions, form three-dimensional replicas of the original tissue. This makes them ideally suited for testing individual system therapies but also as a validation technique for new intraoperative diagnostic procedures. The Research Training Group 2543/I, which is funded by the German Research Foundation, is researching the potential of new diagnostic methods in an interdisciplinary team regarding validation in addition to intraoperative frozen sections.

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Förderung

Die Arbeiten, die in diesem Artikel beschrieben werden, entstanden teilweise im Rahmen der Tätigkeiten im Graduiertenkolleg 2543/1 „Intraoperative Multisensorische Gewebedifferenzierung in der Onkologie“ (Projekt ID 40947457), gefördert von der Deutschen Forschungsgemeinschaft (DFG).

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Authors and Affiliations

  1. Klinik für Urologie, Universitätsklinikum Tübingen, Hoppe-Seyler-Str. 3, 72076, Tübingen, Deutschland

    N. Harland, B. Amend, N. Lipke, W. Aicher & A. Stenzl

  2. Department für Frauengesundheit, Universitäts-Frauenklinik, Universitätsklinikum Tübingen, Tübingen, Deutschland

    S. Y. Brucker

  3. Institut für Pathologie und Neuropathologie, Universitätsklinikum Tübingen, Tübingen, Deutschland

    F. Fend

  4. Institut für Technische Optik, Universität Stuttgart, Stuttgart, Deutschland

    A. Herkommer

  5. Fachbereich Informatik, Computergrafik, Universität Tübingen, Tübingen, Deutschland

    H. Lensch

  6. Institut für Systemdynamik, Universität Stuttgart, Stuttgart, Deutschland

    O. Sawodny & C. Tarín Sauer

  7. Institut für Angewandte Physik, Universität Tübingen, Tübingen, Deutschland

    T. E. Schäffer

  8. Department für Biomedical Engineering, Universität Tübingen, Tübingen, Deutschland

    K. Schenke-Layland

  9. NMI Naturwissenschaftliches und Medizinisches Institut, Universität Tübingen, Reutlingen, Deutschland

    K. Schenke-Layland

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  1. N. Harland
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  2. B. Amend
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  9. T. E. Schäffer
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  10. K. Schenke-Layland
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  11. C. Tarín Sauer
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  13. A. Stenzl
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Corresponding author

Correspondence to N. Harland.

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Interessenkonflikt

N. Harland, B. Amend, N. Lipke, S. Y. Brucker, F. Fend, A. Herkommer, H. Lensch, O. Sawodny, T.E. Schäffer, K. Schenke-Layland, C. Tarín Sauer, W. Aicher und A. Stenzl geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Harland, N., Amend, B., Lipke, N. et al. Organoide zur Weiterentwicklung der intraoperativen Diagnostik. Urologe 60, 1159–1166 (2021). https://doi.org/10.1007/s00120-021-01595-5

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