Investigating the use of fluorescent proteins to identify dysplasia during endoscopy and surgery

本研究项目的目的是寻找一种有前途的新方法来指导医生对患者进行内窥镜检查（结肠镜检查/乙状结肠镜检查）或手术。我们之前使用新鲜组织的工作表明，特殊标记的蛋白质，称为凝集素，可以使组织的异常区域更容易看到。这项研究的目的是测试患者在内窥镜检查中的凝集素，看看他们是否能特异性地识别这些异常区域，与目前的金标准相比，即在内窥镜检查中使用白光。希望这些凝集素能使异常组织在内窥镜检查和手术中更容易看到和去除。这一点很重要，因为准确识别异常组织将使医生能够切除所有异常区域，防止疾病在未来复发。也希望这些凝集素可以帮助在早期阶段识别异常组织（发育不良或癌症），为患者提供更多的治疗选择，减少侵入性，提高治愈率。如果这项研究成功，它可能会导致开发一种简单的工具，可以在结肠镜检查和手术时识别异常组织，这对患者有很大的好处。凝集素是从植物中提取的蛋白质。根据组织是否异常，凝集素与肠壁的结合方式不同。凝集素可以贴上一种特殊染料的标签，这种染料在某种颜色的光线下会发出明亮的光。这被称为荧光，可以用内置在结肠镜中的特殊摄像机捕捉到。我们将以非常低的剂量使用这些凝集素，所以任何副作用，如果有的话，都会非常小。此外，我们只会将其应用于大肠而不是小肠，小肠是吸收大部分营养的地方。因此，我们预计很少的凝集素，如果有的话，将被消化系统吸收。

The purpose of this research project is to look at a promising new way of guiding doctors when they perform endoscopic procedures (colonoscopy/flexible sigmoidoscopy) or surgery on patients.Our previous work using fresh tissue has shown that specially labelled proteins, called lectins, can make abnormal areas of tissue easier to see. The aim of this study is to test lectins in patients undergoing endoscopic examination to see if they can identify these abnormal areas specifically, compared to the current gold standard, that is using white light during endoscopy. It is hoped that these lectins will make the abnormal tissue easier to see and remove during endoscopy and surgery. This is important because the accurate identification of abnormal tissue will allow doctors to remove all abnormal areas preventing the disease from recurring in future. It is also hoped that these lectins can help identify abnormal tissue (dysplasia or cancer) at an earlier stage, allowing more treatment options for patients that are less invasive and with a higher curative rate. If this study is successful, it could lead to the development of a simple tool than can identify abnormal tissue at the time of colonoscopy and surgery, with significant benefits for patients. Lectins are proteins that are derived from plants. Lectins bind differently to the bowel wall, depending on whether or not the tissue is abnormal. Lectins can be labelled with a special dye that shines brightly when viewed under light of a certain colour. This is called fluorescence and can be captured using special cameras, which are built into colonoscopes. We would be using these lectins at very low doses so any side effects, if any, will be very small. Furthermore, we will only be applying it to the large bowel and not the small bowel, where most of the nutrients are absorbed. We therefore expect very little lectin, if any, will be absorbed by the digestive system.