Potential Red-Flag Identification of Colorectal Adenomas with Wide-Field Fluorescence Molecular Endoscopy
Potential Red-Flag Identification of Colorectal Adenomas with Wide-Field Fluorescence Molecular Endoscopy
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DOI：
10.7150/thno.22033
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发表时间：
2018-01-01
期刊：
影响因子：
12.4
通讯作者：
Nagengast, Wouter B.
中科院分区：
文献类型：
--
作者：
Hartmans, Elmire;Tjalma, Jolien J. J.;Nagengast, Wouter B.
结肠镜检查中腺瘤漏诊率高得令人无法接受，尤其是无蒂锯齿状腺瘤/息肉（SSA/Ps）和高危人群，如Lynch综合征患者。荧光分子内镜（FME）可以提高检出率，它可以通过高清晰度白光成像对病变进行形态学可视化，以及通过特定分子标记物对病变进行荧光引导识别。在临床证明的主要研究中，我们调查了FME结直肠腺瘤检测，使用荧光标记抗体（贝伐单抗-800 CW）对血管内皮生长因子A（VEGFA），这是高度上调的结直肠adenoma.Methods：家族性腺瘤性息肉病患者（n = 17），接受静脉注射4.5，10或25毫克的贝伐单抗-800 CW。三天后，他们接受了NIR-FME.Results：VEGF靶向的NIR-FME检测结直肠腺瘤在所有剂量。最高剂量组（25 mg）取得了最佳结果，甚至可以检测到小腺瘤（
Adenoma miss rates in colonoscopy are unacceptably high, especially for sessile serrated adenomas/polyps (SSA/Ps) and in high-risk populations, such as patients with Lynch syndrome. Detection rates may be improved by fluorescence molecular endoscopy (FME), which allows morphological visualization of lesions with high-definition white-light imaging as well as fluorescence-guided identification of lesions with a specific molecular marker. In a clinical proof-of-principal study, we investigated FME for colorectal adenoma detection, using a fluorescently labelled antibody (bevacizumab-800CW) against vascular endothelial growth factor A (VEGFA), which is highly upregulated in colorectal adenomas.Methods: Patients with familial adenomatous polyposis (n = 17), received an intravenous injection with 4.5, 10 or 25 mg of bevacizumab-800CW. Three days later, they received NIR-FME.Results: VEGFA-targeted NIR-FME detected colorectal adenomas at all doses. Best results were achieved in the highest (25 mg) cohort, which even detected small adenomas (