In Vivo Optical Detection of Dysplasia in Barrett's Esophagus

描述(申请人提供)：该计划的目的是为胃肠病医生提供一种诊断筛查工具，使他能够快速检查患有这种疾病的患者的巴雷特食道(BE)区域，并允许他以高概率和实时的方式确定不典型增生和癌的区域。它将能够区分腺癌、高度异型增生、低级异型增生、不确定的异型增生和非异型增生的BE。它将能够在大约10分钟内测量整个食道的长度，并实时提供信息。然后，可以对可疑区域进行活组织检查，并核实诊断。这种方法大大优于目前进行系统或随机活组织检查的策略。因此，它将为筛查大量Barrett‘s食道患者的早期癌前病变提供强有力的工具。 该仪器将基于光散射光谱(LSS)技术，该技术已在一项原则验证研究中证明能够在包括Be在内的五个不同器官的上皮组织中进行此类测量。该技术的优点是，它大大简化了筛查和获得诊断所涉及的时间和人力，将减少患者的不适，需要更少的活检，它可以帮助病理学家根据统一的定量标准进行诊断，使诊断更加一致。由于这些优势，在有可能治愈的早期阶段，它应该会极大地提高发现潜在恶性肿瘤的可能性，而且应该是非常划算的。由于组织不一定被切除，它使进展研究成为可能。这样的研究可以确定疾病结局的准确预测因素，从而简化选择治疗的决定。

DESCRIPTION (provided by applicant): The purpose of this program is to provide the gastroenterologist with a diagnostic screening tool which will enable him to rapidly survey the region of Barrett's esophagus (BE) in a patient with this disease, and allow him to determine with high probability and in real-time, regions of dysplasia and carcinoma. It will be able to distinguish between the categories of adenocarcinoma, high-grade dysplasia, low-grade dysplasia, indefinite for dysplasia and non-dysplastic BE. It will be able to perform measurements of the full length of the esophagus in about ten minutes and provide the information in real time. Suspicious areas can then be biopsied and the diagnosis verified. This approach is vastly superior to the present strategies of performing either systematic or random biopsies. Thus it will provide a powerful tool for screening the large population of Barrett's esophagus patients for early precancerous changes. This instrument will be based on the technique of light scattering spectroscopy (LSS), which has been demonstrated in a proof-of-principle study to be able to perform such measurements in the epithelial tissue of five different organs, including BE. The advantages of the proposed technique are that it greatly simplifies the time and labor involved in performing screening and obtaining diagnoses, will cause less patient discomfort, require fewer biopsies, and it can help the pathologist to base his diagnosis on uniform quantitative criteria, making the diagnosis more consistent. Because of these advantages, it should vastly improve the probability of detecting potential malignancies in the early stages, when cures are possible, and it should be highly cost effective. Since tissue is not necessarily removed, it makes possible progression studies. Such studies may determine accurate predicative factors for the outcome of the disease, and thus simplify the decision in the choice of treatment.