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

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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.