Spectroscopy and fluorescence in esophageal diseases.
Best Pract Res Clin Gastroenterol
; 20(1): 41-57, 2006 Feb.
Article
en En
| MEDLINE
| ID: mdl-16473800
Malignant tumors of the esophagus continue to be a major health issue associated with high mortality primarily because most present with symptoms of dysphagia or anaemia. The disease at that stage is advanced and not likely curable. The big issue for squamous dysplasia and that associated with BE is that only a small proportion are discovered in surveillance programs when they are asymptomatic, either because the patient lives in a high-incidence geographical area, has a family history, previously diagnosed head and neck cancer or chronic reflux, as in Barrett's. Current endoscopic methods are hampered by the endoscopist's inability to recognize subtle topographic clues of dysplasia, sampling errors related to biopsy protocols, and confounding inflammation-induced artifacts both for the endoscopist and pathologist. What is desperately needed would be a biomarker (e.g. serological, fecal, urinary) that selects patients for endoscopy. However, such a test is not yet on the horizon. This article examines the current status in practice and research of novel optically based 'bioendoscopic' devices (i.e. fluorescence spectroscopy and imaging, confocal fluorescence microendoscopy (CFM), light scattering spectroscopy (LSS), Raman spectroscopy (RS), and immunophotodiagnostic endoscopy) which may enhance the diagnosis of dysplasia in all patients undergoing conventional white light endoscopy. Perhaps these new technologies will lead to more cost-effective diagnosis, mapping (e.g. surface), and staging (e.g. depth) of dysplasia, thereby allowing timely cure by endoscopic means (e.g. EMR and/or PDT), biological interventions (e.g. Cox-2 inhibitors) rather than esophajectomy.
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Bases de datos:
MEDLINE
Asunto principal:
Espectrometría de Fluorescencia
/
Endoscopía Gastrointestinal
/
Microscopía Confocal
/
Enfermedades del Esófago
Tipo de estudio:
Guideline
Límite:
Humans
Idioma:
En
Revista:
Best Pract Res Clin Gastroenterol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2006
Tipo del documento:
Article
País de afiliación:
Canadá