In situ detection of nuclear atypia in Barrett's esophagus by using angle-resolved low-coherence interferometry
In situ detection of nuclear atypia in Barrett's esophagus by using angle-resolved low-coherence interferometry
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DOI：
10.1016/j.gie.2006.10.016
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发表时间：
2007-03-01
影响因子：
7.7
通讯作者：
Wax, Adam
中科院分区：
文献类型：
--
作者：
Pyhtila, John W.;Chalut, Kevin J.;Wax, Adam
背景：目前对巴雷特食管（BE）异常增生患者的监测是通过系统活检来完成的，可以通过增加危险组织的检查比例来改进。目的：光学活检技术不切除组织，而是用光询问组织，为改善BE的监测提供了一种潜在的方法。频域角分辨低相干干涉技术（fa/LCI）是一种通过内窥镜光纤束应用的光谱学技术，可测量组织的深度分辨核形态，这是识别非典型增生的关键生物标志物。本研究的目的是评估fa/LCI在BE患者中区分健康组织和发育不良组织的诊断能力。方法：采用fa/LCI对3例食管胃切除术患者的组织进行深度分辨角散射数据采集。对数据进行处理以确定平均核尺寸和密度作为组织表面下深度的函数。将这些数据与组织的病理分类进行比较。主要结果测量：组织样品中深度分辨核直径和核密度测量的平均值。结果：与病理诊断相比，fa/LCI数据结果报告了上皮组织异常增生的核非典型特征。对表面150 μ m的平均核形态检查显示健康柱状组织和BE发育不良组织完全分离。局限性：缺乏体内数据；由于样本量有限，缺乏非发育不良的BE数据。结论：在复杂的组织结构中，如BE，深度分辨核形态学测量提供了识别不典型增生的极好方法。初步结果表明，fa/LCI作为BE患者物理活检的靶向机制在体内的应用潜力巨大。
Background: Monitoring of patients with Barrett's esophagus (BE) for dysplasia, currently done by systematic biopsy, can be improved through increasing the proportion of at-risk tissue examined.Objective: Optical biopsy techniques, which do not remove the tissue but interrogate the tissue with light, offer a potential method to improve the monitoring of BE. Frequency-domain angle resolved low-coherence interferornetry (fa/LCI) is an optical spectroscopic technique applied through an endoscopic fiber bundle and measures the depth-resolved nuclear morphology of tissue, a key biomarker for identifying dysplasia. The aim of the study was to assess the diagnostic capability of fa/LCI for differentiating healthy and dysplastic tissue in patients with BE.Methods: Depth-resolved angular scattering data are acquired by using fa/LCI from tissue excised from 3 patients who had esophagogastrectomy. The data are processed to determine the average nuclear size and density as a function of depth beneath the tissue surface. These data are compared with the pathologic classification of the tissue.Main Outcome Measurements: Average of depth-resolved nuclear diameter and nuclear density measurements in tissue samples.Results: Upon comparison to pathologic diagnosis, the fa/LCI data results report the nuclear atypia characteristic of dysplasia in the epithelial tissue. Examination of the average nuclear morphology over the superficial 150 mu m results in complete separation between healthy columnar and BE dysplastic tissues.Limitations: Lack of in vivo data; lack of nondysplastic BE data because of limited sample size.Conclusions: In complicated tissue structures, such as BE, depth-resolved nuclear morphology measurements provided an excellent means to identify dysplasia. The preliminary results demonstrate the great potential for the in vivo application of fa/LCI as a targeting mechanism for physical biopsy in patients with BE.