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

该研究项目的目的是寻找一种有前途的新方法，指导医生在对患者进行内窥镜检查（结肠镜/乙状结肠镜）或手术时进行指导。我们以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。本研究的目的是测试接受内镜检查的患者的凝集素，以观察与目前的金标准（即在内镜检查期间使用白色光）相比，它们是否可以特异性地识别这些异常区域。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。人们还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，这些治疗选择的侵入性更小，治愈率更高。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，为患者带来显着的好处。凝集素是来源于植物的蛋白质。凝集素与肠壁的结合方式不同，这取决于组织是否异常。凝集素可以用一种特殊的染料标记，当在某种颜色的光下观察时，这种染料会发出明亮的光。这被称为荧光，可以使用内置在结肠镜中的特殊摄像头捕获。我们将以非常低的剂量使用这些凝集素，因此任何副作用，如果有的话，将非常小。此外，我们只会将其应用于大肠，而不是小肠，因为大多数营养物质都是在小肠吸收的。因此，我们预计消化系统吸收的凝集素很少（如果有的话）。

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.