Association between rectal optical signatures and colonic neoplasia: potential applications for screening.
Association between rectal optical signatures and colonic neoplasia: potential applications for screening.
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DOI：
10.1158/0008-5472.can-08-4780
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发表时间：
2009-05-15
期刊：
影响因子：
11.2
通讯作者：
Backman V
中科院分区：
文献类型：
--
作者：
Roy HK;Turzhitsky V;Kim Y;Goldberg MJ;Watson P;Rogers JD;Gomes AJ;Kromine A;Brand RE;Jameel M;Bogovejic A;Pradhan P;Backman V
尽管目前的技术（例如柔性乙状结肠镜检查）缺乏必要的灵敏度，但现场致癌检测代表了结直肠癌（CRC）筛查的一种有前途的手段。新型光学技术低相干增强后向散射 (LEBS) 光谱能够以前所未有的精度识别临床前 CRC 模型中现场致癌的微尺度结构后果。为了研究这种方法潜在的临床可转化性，我们从接受结肠镜检查的患者 (n = 219) 的外观正常的直肠粘膜中获取了活检组织。 LEBS 信号通过台式仪器记录。表征 LEBS 信号的四个参数线性组合成单个标记。我们发现，LEBS 信号参数通常反映了从无瘤形成患者到 5 至 9 mm 腺瘤和晚期腺瘤的瘤形成进展。根据 LEBS 信号计算的复合 LEBS 标记与此风险状态平行（方差分析 P < 0.001）。此外，这与结直肠癌危险因素、良性结肠发现或临床上不重要的病变（小腺瘤、增生性息肉）无关。对于晚期腺瘤，LEBS 标记的敏感性为 100%，特异性为 80%，受试者工作特征曲线下面积为 0.895。留一法交叉验证和独立数据集（n = 51）支持了这些发现的稳健性。总之，我们首次证明内镜下正常直肠中可检测到的 LEBS 改变与结肠其他部位肿瘤的存在相关。这项研究提供了概念证明，即直肠 LEBS 分析可能提供一种侵入性最低的 CRC 筛查技术。正在进行内窥镜兼容光纤探头的进一步研究，以进行多中心临床验证。
Field carcinogenesis detection represents a promising means for colorectal cancer (CRC) screening, although current techniques (e.g., flexible sigmoidoscopy) lack the requisite sensitivity. The novel optical technology low-coherence enhanced backscattering (LEBS) spectroscopy, allows identification of microscale architectural consequences of the field carcinogenesis in preclinical CRC models with unprecedented accuracy. To investigate the potential clinical translatability of this approach, we obtained biopsies from the normal-appearing rectal mucosa from patients undergoing colonoscopy (n = 219). LEBS signals were recorded through a bench-top instrument. Four parameters characterizing LEBS signal were linearly combined into a single marker. We found that LEBS signal parameters generally mirrored neoplasia progression from patients with no neoplasia, to 5 to 9 mm adenoma and to advanced adenomas. The composite LEBS marker calculated from the LEBS signal paralleled this risk status (ANOVA P < 0.001). Moreover, this was independent of CRC risk factors, benign colonic findings, or clinically unimportant lesions (diminutive adenomas, hyperplastic polyps). For advanced adenomas, the LEBS marker had a sensitivity of 100%, specificity of 80%, and area under the receiver operator characteristic curve of 0.895. Leave-one-out cross-validation and an independent data set (n = 51) supported the robustness of these findings. In conclusion, we provide the first demonstration that LEBS-detectable alterations in the endoscopically normal rectum were associated with the presence of neoplasia located elsewhere in the colon. This study provides the proof of concept that rectal LEBS analysis may potentially provide a minimally intrusive CRC screening technique. Further studies with an endoscopically compatible fiber optic probe are under way for multicenter clinical validation.