In Vivo Optical Detection of Dysplasia in Esophagus

项目摘要 食管腺癌是西方国家最常见的食管恶性肿瘤， 恶性肿瘤在美国增长最快-在过去30年中每年约7% 年它的预后非常差，诊断后5年存活的患者不到15%。在世界范围内， 2008年发生了482，300例新发食管癌病例和406，800例死亡。为了让患者 为了生存，必须在早期发育不良阶段诊断这种恶性肿瘤。我们集团 开发了一种内窥镜偏振光谱扫描（EPSS）仪器，该仪器可以提供真实的时间， 关于不可见的高度异型增生位置的体内信息。这与现有的 商业内窥镜，多光谱成像仪器是基于光散射技术 光谱（LSS），能够识别各种上皮衬里器官中的癌前病变，如 食道EPSS成像仪器在几分钟内扫描整个食管， 医生可获得用于指导活检的真实的实时诊断信息。 同时，为了建立EPSS方法的无偏特性， 为胃肠病学家提供所需的准确定量组织学和生化信息， 可视化不可见的食管上皮异型增生重要的技术改进， 需要进行更多的临床研究。对于这个有竞争力的更新计划，我们将建立一个显着的 能够更快地扫描整个食管数量级的改进的便携式EPSS仪器 然后利用现有仪器，深度分辨上皮结构，并连续投影定量， 真实的内窥镜视频上的组织学和生物化学以及诊断成像信息 时间 与最先进的宽场技术相比，EPSS的特点是能够定位 当用白色光观察时，组织中的发育不良显示无可见异常或病变，或 荧光。通过用宏观光谱测量阐明微观亚细胞结构， EPSS可以独立于任何视觉线索定位发育不良组织。我们得出结论，EPSS提供了巨大的 有望早期发现Barrett食管发育不良。如果EPSS技术 用于指导常规活检，将避免不必要的活检， 进行活检，否则将被错过。

Project Summary Esophageal adenocarcinoma is the most common esophageal malignancy in Western world and the malignancy that is rising the fastest in the United States – approximately 7% per year over the past 30 years. It has very poor prognosis with less than 15% of patients alive 5 years after diagnosis. Worldwide, 482,300 new esophageal cancer cases and 406,800 deaths occurred in 2008. In order for patients to survive, it is essential to diagnose this malignancy at an early, dysplastic stage. Our group has developed an endoscopic polarized spectroscopic scanning (EPSS) instrument which gives real time in vivo information on the location of invisible high grade dysplasia. This, compatible with existing commercial endoscopes, multispectral imaging instrument is based on the technique of light scattering spectroscopy (LSS), capable of identifying pre-cancer in various epithelial-lined organs, such as esophagus. The EPSS imaging instrument scans the entire esophagus in a matter of minutes providing the physician with real time diagnostic information for guiding biopsy. At the same time, in order to establish unbiased characteristics of the EPSS method and to provide gastroenterologists with accurate quantitative histological and biochemical information needed to visualize invisible dysplasia in esophageal epithelium important technological improvements and additional clinical studies are required. For this competitive renewal program we will build a significantly improved portable EPSS instrument capable of scanning the entire esophagus order of magnitude faster then the existing instrument, depth resolving epithelial structure, and continuously projecting quantitative histological and biochemical as well as diagnostic imaging information on the endoscopy video in real time. Compared to state-of-the-art wide-field techniques, EPSS is distinguished by its ability to locate dysplasia in tissue that shows no visible abnormalities or lesions when observed with white light or fluorescence. By elucidating microscopic subcellular structure with macroscopic spectral measurements, EPSS can locate dysplastic tissue independent of any visual cues. We conclude that EPSS offers great promise for the early detection of dysplasia in Barrett's esophagus. If the EPSS technique were to be used to guide biopsy routinely, unnecessary biopsies would be avoided and focal dysplastic spots would be biopsied that otherwise would be missed.