Electron microscopy to detect cellular apoptosis in mesothelioma
Research type
Research Study
Full title
Measuring iodine induced cancer cell death in patients with malignant pleural mesothelioma
IRAS ID
194317
Contact name
Andrea Bille
Contact email
Sponsor organisation
Guy's & St Thomas' Foundation NHS Trust
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
This study evaluates the the accuracy of electron microscopy when compared to immunohistochemistry in assessing povidone-iodine induced cellular apoptosis in malignant mesothelioma. Previous studies have demonstrated that povidone-iodine causes increased tumor cell death (apoptosis) in laboratory models. Alaboratory method known as immunohistochemistry is the standard way to determine the degree in which povidone-iodine has caused damage to tumour cells. As a result the use of povidone-iodine in clinical practice has increased, however the effectiveness of a technique known as election microscopy to determine the cellular changes caused by this povidone-iodine is yet to be evaluated. This study will enrol patients with proven or likely cancer of the lining of the lung (malignant pleural mesothelioma) who are undergoing thoracic surgery as part of the routine management of their condition. We will compare the effectiveness of electron microscopy to that of conventional immunohistochemistry in determining the death rate of cancer cells.
During the operation, all patients will receive hyperthermic povidone-iodine lavage (washing the pleural cavity with warm povidone-iodine) according to a well-established protocol (Lang Lazdunski et al. Journal of Thoracic Oncology, 2012). During the operation, 3 biopsies will be performed: At the beginning and after lavage. These biopsies will be examined under the electron microscope to assess whether povidone-iodine increases cancer cell death. In addition, the expression of 2 key genetic markers of tumor division (p53 and Bcl-2) will be examined in all biopsies, and the pleural fluid will be examined for changes in its cell make-up using a technique called flow cytometry. These findings will then be compared to the results of standard immunohistochemistry. The results will subsequently be analysed using standard statistical methodology.
REC name
London - Riverside Research Ethics Committee
REC reference
16/LO/1081
Date of REC Opinion
23 Sep 2016
REC opinion
Further Information Favourable Opinion