JP2022102146A - Tumor sampler - Google Patents

Abstract

To provide a tumor sampler capable of collecting a plurality of adjacent specimens from a tumor.SOLUTION: A tumor sampler 100 includes: a plurality of collection tubes 110a and b having a plurality of distal end openings for collecting a plurality of specimens; a lid body 121 for closing the plurality of distal end openings; and a collection tube housing body 120 for housing at least a part of each of the plurality of collection tubes 110a and b, which can slide along a longitudinal direction of the plurality of collection tubes. When the lid body 121 is connected to the collection tube housing body 120, and the collection tube housing body 120 is slid, the lid body 121 is moved between an open state in which the lid body 121 opens the distal end openings and a closed state in which the lid body 121 closes the distal end openings.SELECTED DRAWING: Figure 1

Description

The present invention relates to a tumor sampler that collects a plurality of specimens from a tumor.

In recent years, gene analysis techniques for tumors such as brain tumors have been rapidly advanced. Therefore, it is expected that the importance of gene analysis will continue to increase in the diagnosis of tumors and the decision of treatment policy.

As a prior art related to sample collection required for gene analysis as described above, for example, Patent Document 1 discloses a prostate biopsy needle.

When such a biopsy needle is used, as disclosed in Patent Document 1, the doctor places the handle 44 on the palm of the right hand and causes the new finger type 46 to protrude outward. Further, the doctor places the fingertip of the index finger 76 on the tip of the guide tube 30 in which the stylet 10 and the cannula 20 are completely retracted so that the tip of the stylet 10 having a sharp portion is pressed against the fingertip. The physician uses only his right hand to bring the index finger 76 and guide tube 30 into contact with the surface near the patient's tissue. The doctor can then push the sharp tip of the stylet 10 into the tissue. The doctor then uses his left hand to push the bush knob 50 forward and pierce the tissue with the stylet 10.

Japanese Patent Publication No. 4-63692 (US Patent No. 4600014)

By the way, as a problem in gene analysis, there is a problem related to intratumoral heterogeneity. For example, in tumors such as brain tumors typified by glioma, cells in the tumor undergo clonal evolution while forming diverse cell populations with different gene profiles.

That is, in a tumor, cell populations having various gene profiles are irregularly generated and distributed, and the properties of cells constituting the tumor may also vary depending on the location. That is, the tumor exhibits heterogeneity in its composition. Therefore, relapse and treatment resistance may differ in each region of the tumor.

On the other hand, in the current biopsy needle, a sample is randomly collected from one place in the tumor, and no consideration is given to the inhomogeneity in the tumor. Therefore, there may be a case where the relapse or treatment resistance of the place where the sample is collected happens to be analyzed and used as the property of the tumor. This situation also leads to concerns that the accuracy of tumor diagnosis and treatment decision making may be reduced.

Therefore, an object of the present invention is to provide a tumor sampler capable of collecting a plurality of adjacent specimens from a tumor. Alternatively, an object of the present invention is to provide a tumor sampler that enables analysis of intratumoral heterogeneity by collecting a plurality of adjacent specimens.

Each aspect of the present invention is as follows.
[Aspect 1]
A tumor sampler that collects multiple adjacent specimens from a tumor.
A tumor sampler comprising a plurality of collection tubes having a plurality of distal end openings for collecting the plurality of specimens and a lid closing the plurality of distal end openings.
[Aspect 2]
In the tumor sampler according to aspect 1,
Further provided with a slide body that can slide along the longitudinal direction of the plurality of collection tubes.
The lid is connected to the slide, and by sliding the slide, the lid opens the plurality of distal end openings, and the lid opens the plurality of distal end openings. A tumor sampler in which the lid moves between a closed state that closes the portion.

[Aspect 3]
In the tumor sampler according to aspect 2,
The slide body is a tumor sampler that is a collection tube container that houses at least a part of each of the plurality of collection tubes.
[Aspect 4]
In the tumor sampler according to aspect 2 or 3,
The lid has an elastic and bendable bend.
The bent portion is a tumor sampler in which the bent portion is stretched in the open state and the bent portion is bent in the closed state.
[Aspect 5]
In the tumor sampler according to aspect 4,
The slide body is a tumor sampler comprising a slide body opening closed by the lid body in the closed state.

[Aspect 6]
In the tumor sampler according to aspect 5,
A tumor sampler in which the slide opening is inclined with respect to the longitudinal direction of the plurality of collection tubes.
[Aspect 7]
In the tumor sampler according to any one of aspects 1 to 6,
A tumor sampler comprising a handle that slides the slide body along the plurality of collection tubes.
[Aspect 8]
In the tumor sampler according to aspect 7,
A tumor sampler comprising a main body that holds the plurality of collection tubes, the main body including a slide control unit that controls the slide of the slide body.

[Aspect 9]
In the tumor sampler according to aspect 8,
The slide control unit is a tumor sampler including a handle contact portion that contacts the flat surface of the handle to limit the slide.
[Aspect 10]
In the tumor sampler according to any one of aspects 1 to 9.
The lid is a tumor sampler with a cutting blade at its tip.
[Aspect 11]
In the tumor sampler according to any one of aspects 1 to 10.
A tumor sampler in which the plurality of collection tubes are arranged in parallel with each other.

[Aspect 12]
In the tumor sampler according to any one of aspects 1 to 11.
The distal end opening is a tumor sampler comprising a sampling blade for collecting the sample.
[Aspect 13]
The tumor sampler according to any one of aspects 1 to 12.
A tumor sampler further comprising a connection at the proximal end opening of each of the plurality of collection tubes to connect with a liquid press-fitting tool.
[Aspect 14]
The tumor sampler according to any one of aspects 1 to 13.
The body is a tumor sampler with markers for surgical navigation.

The tumor sampler of the present invention can collect a plurality of adjacent specimens from a tumor. Further, in the tumor sampler of the present invention, by collecting a plurality of adjacent specimens from a tumor, the tumor can be collected transversely to a plurality of collection tubes and continuously along a plurality of collection tubes. can.

It is a perspective view which shows the tumor sampler which concerns on 1st Embodiment. It is a top view which shows the tumor sampler which concerns on 1st Embodiment. It is a side view which shows the tumor sampler which concerns on 1st Embodiment. It is a top view which shows the tumor sampler which concerns on 2nd Embodiment. It is a side view which shows the tumor sampler which concerns on 2nd Embodiment. It is an enlarged sectional view of the distal end opening of a plurality of collection tubes.

Embodiments of the present invention relating to the tumor sampler will be described with reference to the drawings. The corresponding parts in each figure are designated by the same reference numerals, and the description thereof will be omitted as appropriate. In the present embodiment, the end close to the tumor sampler doctor or the like is referred to as the proximal end side P, and the end far from the operator such as the tumor sampler doctor or the like is referred to as the distal end side. Say D. 1 (a) and 2 show the proximal end side P and the distal end side D with arrows.

[First Embodiment]
The configuration of the tumor sampler 100 of the first embodiment will be described. FIG. 1 is a perspective view showing a tumor sampler according to the first embodiment. 2 is a top view showing the tumor sampler according to the first embodiment, and FIG. 3 is a side view. FIG. 6 is an enlarged cross-sectional view of the distal end openings of the plurality of collection tubes.

The tumor sampler 100 of the first embodiment includes a plurality of adjacent collection tubes 110a and b, a collection tube accommodating body (slide body) 120 accommodating at least a part of each of the plurality of collection tubes 110a and b, and a plurality of collection tubes 110a and b. It is composed of a main body 130 that holds (fixes) the collection tubes 110a and b at the proximal end side P, and a syringe connection portion 140 provided at the proximal end of each collection tube 110a and b. The collection tube accommodating body 120 is slidable along the longitudinal direction of the plurality of collection tubes 110a and b. A lid 121 is formed at the distal end of the collection tube container 120. The lid 121 makes it possible to close the distal end openings 111 of the plurality of collection tubes 110a and b. The container opening (slide body opening) 125 of the collection tube housing 120 is preferably inclined with respect to the longitudinal direction of the plurality of collection tubes 110a and b, as shown in FIGS. 3 and 6A. ing.

The collection tube accommodating body 120 can preferably be a tubular body having a flat cross section. Each collection tube 110a, b is preferably connected to each other and / or can extend in parallel. Each collection tube 110a, b can preferably be a cylindrical tube. The tumor sampler 100 can preferably be formed from a material having heat resistance (autoclaveable material) capable of sterilizing the whole or a plurality of collection tubes thereof. As such a material, for example, a metal such as stainless steel can be used. Alternatively, the tumor sampler 100 is preferably formed entirely or in part from a resin material and is disposable.

As shown in FIG. 1A, the distal end openings 111 of each collection tube 110a, b may be preferably circular, and more preferably provided with a collection blade 112 for collecting a sample from tissue 1. can. The sampling blade 112 can preferably have a shape that is annularly inclined toward the central axis of the sampling tube at the end surface of the distal end opening 111. By using the collection blade 112 formed on each collection tube 110a and b, a plurality of samples can be cut into a columnar shape from the tissue 1.

Further, the main body 130 fixes the collection tubes 110a and b at the proximal end side P, and holds the collection tube accommodating body 120 at the proximal end side P so as to be slidable. Each collection tube 110a, b is preferably bent (Y-shaped) so as to be separated from each other at the proximal end side P. A syringe connection portion 140 is provided at the end of the proximal end side P of each collection tube.

A marker for surgical navigation can also be preferably placed on the main body 130. This marker can be a reflective marker used in a mechanism for detecting the tip position of a pointer probe in a surgical navigation system. In the surgical navigation system, the position of the reflected light of the reference frame, which is the optical reference point for navigation, and the reflected light of the reflection marker provided on the surface of the main body 130 is measured by an infrared camera based on the principle of triangular measurement, and the pointer probe is used. The position information of the tip of the can be displayed in real time on an image such as CT or MRI taken before the operation.

On the other hand, the syringe connecting portion 140 is a jig for connecting a syringe (liquid press-fitting tool) for injecting physiological saline into each of the sampling tubes 110a and b. Therefore, it can be made of an elastic body having a lumen that matches the shape of the head of the syringe body and having wearability and holding property such as rubber. When a pressing operation is performed with a syringe connected to the syringe connection portion 140, the physiological saline solution in the syringe is press-fitted into the lumens of the collection tubes 110a and b via the syringe connection portion 140. ..

Due to the water pressure of the physiological saline solution, a plurality of specimens taken into the lumen from the distal ends of the plurality of collection tubes 110a and b are collected from the respective distal end openings 101 in the open state of the lid 121 described later. It can be discharged.
In each embodiment, the plurality of collection tubes 110a and b may be, for example, a pathological sample collection collection tube and a gene analysis sample collection collection tube, respectively.

As shown in FIG. 1 (b), the lid 121 includes a cutting blade 123 formed at the tip thereof and a bent portion 124 having elasticity and bending. The bent portion 124 is formed on the proximal end side P of the cutting blade 123. The bent portion 124 can take the first arrangement of FIGS. 1 (a) and 6 (a) and the second arrangement of FIGS. 1 (b) and 6 (b). In the first arrangement, the cutting blade 123 slides toward the proximal end side and stays on the longitudinal planes of the sampling tubes 110a and b. In the first arrangement, the collection tubes 110a and b are stretched and substantially flat, and the lid 123 is in an open state in which the distal end openings 111 of the collection tubes 110a and b are opened. On the other hand, in the second arrangement, the lid 121 is slid toward the distal end side D, the lid 121 is bent starting from the bent portion 124, and the distal end openings 111 of the sampling tubes 110a and b are collected. It is housed in the tube container 120, and the container opening 125 is closed to be in a closed state.

In order to enable the open state and the closed state, the bent portion 124 has elasticity and is preliminarily bent in the bending direction. As the material of the bent portion 124, for example, a metal material having appropriate elasticity can be used.

Further, on the proximal end side P of the collection tube accommodating body 120, a handle 126 for sliding the collection tube accommodating body 120 so as to be able to advance and retreat in the longitudinal direction with respect to the collection tube 110a and b is formed. The main body 130 is formed with a slide control unit 137 that controls the slide range of the handle 126. The handle 126 is operated by a doctor or the like when sliding the lid 121 to the distal end side D / proximal end side P.

By sliding the lid 121 to the distal end side D, the lid 121 and the cutting blade 123 project beyond the distal ends of the collection tubes 110a and b toward the tissue 1 side, and descend from the bent portion 124 as a starting point. It collapses and bends. With the lid 121 bent, the cutting blade 123 diagonally separates a plurality of specimens from the tissue 1, while the lid 121 closes the retainer opening 125.

Further, by the sliding operation to the proximal end side P of the lid 121, the lid 121 and the cutting blade 123 are in a state of being pushed out from the state of protruding outward from the distal end of the collection tube accommodating body 120. The distal end opening 101 is opened.

Further, the slide control unit 137 can preferably be a flat plate-shaped projecting piece projecting from the main body 130 to the distal side D. The slide control unit 137 regulates the range in which the lid 121 and the collection tube accommodating body 120 are slid to the distal end side D / proximal end side P with respect to the collection tubes 110a and b when the handle 126 is operated. Has an elongated hole (slot) 137a. By operating the handle 126, the lid 121 can be moved to a position where the distal end opening 101 of the collection tube accommodating body 120 is closed / opened.

[Second Embodiment]
The configuration of the tumor sampler 100A of the second embodiment will be described with reference to FIGS. 4 and 5. The tumor sampler 100A has a structure that regulates the operation of the handle 126, and in addition to the slide control unit 137 and the elongated hole 137a of the first embodiment, the direction (upper) intersecting the longitudinal direction of each collection tube 110a, b. It is provided with a handle contact portion 138 extending to. The handle contact portion 138 contacts the plane of the handle 126 at the slide limit position to the distal end side D to limit the slide.

[Usage of tumor sampler]
Subsequently, a usage mode of the tumor sampler 100 of the first embodiment will be described. It is assumed that a doctor or the like operates a tumor sampler 100 and collects a sample from a patient's tumor. Since the usage mode of the tumor sampler 100A of the second embodiment is the same as that of the first embodiment, the description thereof will be omitted.

In this case, a doctor or the like arranges the tumor sampler 100 on the surface of the tissue 1 having a tumor in the state of FIG. 1 during an operation for excision of a brain tumor or the like. In this state, the doctor or the like inserts the distal end openings 111 of the collection tubes 110a and b into the tissue 1. During the operation, the doctor or the like can preferably confirm the insertion direction and the depth of the tumor sampler 100 by a surgical navigation system using a marker.

By the above-mentioned insertion operation, a tumor sample is collected in each of the collection tubes 110a and b. After the collection tubes 110a and b are inserted to the predetermined positions, the doctor or the like keeps the positions of the collection tubes 110a and b, and the doctor or the like points the handle 126 toward the distal end side P of the collection tube container 120. Slide to.

By this slide operation, the cutting blade 123 of the lid 121 closes the container opening 125 of the collection tube container 120 while diagonally cutting the tumor sample connected to the tissue 1. Further, since the container opening 125 of the collection tube container 120 is closed, the tumor sample is held in the collection tubes 110a and b contained in the collection tube container 120. The tumor sampler 100 is moved from the tissue 1 to the outside of the surgical field in a closed state (FIG. 1 (b)) in which the tumor sample is held in each collection tube 110a and b.

After that, doctors and the like slide the collection tube container 120 toward the proximal end by pushing the handle 126 toward the proximal end P with respect to the closed tumor sampler 100, and open the lid 121. (FIG. 1 (a)). In the open state, a syringe containing physiological saline is bound to the syringe coupling portion 140. Further, a saline solution is press-fitted from the syringe toward the syringe connection portion 140, and the tumor sample is extruded and collected from the distal end openings 111 of the collection tubes 110a and b by the saline solution.

As a result, columnar tumor samples are collected from the collection tubes 110a and 110b. The pathological examination of the sample collected from each collection tube 110a can be performed, and the gene analysis of the sample collected from the collection tube 110b can be performed as needed.

[summary]
The tumor sampler in each embodiment can collect a plurality of adjacent specimens from the tumor in a cross-sectional manner with respect to the plurality of collection tubes and continuously along the plurality of collection tubes. This allows analysis of intratumoral heterogeneity. Such a tumor sampler enables cross-sectional and continuous collection of specimens even in tumors in which cell populations of various gene profiles are irregularly generated and distributed, that is, tumors showing heterogeneity.

According to the tumor sampler of the present invention, it is possible to simultaneously collect a plurality of samples, that is, a pathological test sample and a genetic test sample from adjacent sites while maintaining the position information in the tumor. be. Therefore, doctors and the like can perform genetic analysis of the site corresponding to the pathological findings according to the site of the tumor. In addition, depending on the pathological findings, it is also possible to select and analyze the site for gene analysis later.

It is also possible to analyze the evolution of intratumoral clones by specifying the distribution and transition of the gene profile of the cell population in the tumor based on the above-mentioned sample.

In addition, for doctors and the like who handle this tumor sampler, the procedure at the time of operation is simple, and there is no risk of adversely affecting the tumor removal operation. Therefore, it can be used without burden as part of a routine in daily clinical practice.

1 Tissue 100 Tumor sampler 111 Distal end opening 110a Sampling tube 110b Sampling tube 120 Sampling tube Container 121 Lid 123 Cutting blade 124 Bending part 125 Containing body opening 126 Handle 130 Main body 137 Slide control unit 140 Syringe connection 100A Tumor sampler 138 Handle contact

Claims (14)

A tumor sampler that collects multiple adjacent specimens from a tumor.
A tumor sampler comprising a plurality of collection tubes having a plurality of distal end openings for collecting the plurality of specimens and a lid closing the plurality of distal end openings. In the tumor sampler according to claim 1,
Further provided with a slide body that can slide along the longitudinal direction of the plurality of collection tubes.
The lid is connected to the slide, and by sliding the slide, the lid opens the plurality of distal end openings, and the lid opens the plurality of distal end openings. A tumor sampler in which the lid moves between a closed state that closes the portion. In the tumor sampler according to claim 2,
The slide body is a tumor sampler that is a collection tube container that houses at least a part of each of the plurality of collection tubes. In the tumor sampler according to claim 2 or 3.
The lid has an elastic and bendable bend.
The bent portion is a tumor sampler in which the bent portion is stretched in the open state and the bent portion is bent in the closed state. In the tumor sampler according to claim 4,
The slide body is a tumor sampler comprising a slide body opening closed by the lid body in the closed state. In the tumor sampler according to claim 5,
A tumor sampler in which the slide opening is inclined with respect to the longitudinal direction of the plurality of collection tubes. In the tumor sampler according to any one of claims 1 to 6.
A tumor sampler comprising a handle that slides the slide body along the plurality of collection tubes. In the tumor sampler according to claim 7.
A tumor sampler comprising a main body that holds the plurality of collection tubes, the main body including a slide control unit that controls the slide of the slide body. In the tumor sampler according to claim 8,
The slide control unit is a tumor sampler including a handle contact portion that contacts the flat surface of the handle to limit the slide. In the tumor sampler according to any one of claims 1 to 9.
The lid is a tumor sampler with a cutting blade at its tip. In the tumor sampler according to any one of claims 1 to 10.
A tumor sampler in which the plurality of collection tubes are arranged in parallel with each other. In the tumor sampler according to any one of claims 1 to 11.
The distal end opening is a tumor sampler comprising a sampling blade for collecting the sample. The tumor sampler according to any one of claims 1 to 12.
A tumor sampler further comprising a connection at the proximal end opening of each of the plurality of collection tubes to connect with a liquid press-fitting tool. The tumor sampler according to any one of claims 1 to 13.
The body is a tumor sampler with markers for surgical navigation.

Images