Endoscopic Raman spectroscopy enables objective diagnosis of dysplasia in Barrett's esophagus.
Gastrointest Endosc
; 79(1): 37-45, 2014 Jan.
Article
em En
| MEDLINE
| ID: mdl-23886354
ABSTRACT
BACKGROUND:
Early detection and targeted endoscopic resection of Barrett's esophagus-associated high-grade dysplasia (HGD) can prevent progression to invasive esophageal malignancy. Raman spectroscopy, a highly sophisticated analytical technique, has been translated into an endoscopic tool to facilitate rapid, objective diagnosis of dysplasia in the esophagus.OBJECTIVE:
To evaluate the ability of endoscopic Raman spectroscopy (ERS) to objectively detect esophageal HGD and adenocarcinoma.DESIGN:
A total of 798 one-second spectra were measured from 673 ex vivo esophageal tissue samples, collected from patients with Barrett's esophagus by using a novel endoscopic Raman probe. Spectra were correlated with consensus histopathology. Multivariate analysis was used to evaluate the classification accuracy of ERS ex vivo.SETTING:
Probe measurements were conducted in the laboratory. Tissue specimens were collected from the operating theatre and endoscopy unit. PATIENTS Tissue from 62 patients was included in the study.INTERVENTIONS:
Endoscopic biopsy/resection or esophagectomy was performed where indicated clinically. MAIN OUTCOME MEASUREMENT Diagnostic performance of ERS for detection of HGD and esophageal adenocarcinoma.RESULTS:
ERS demonstrated a sensitivity of 86% and a specificity of 88% for detecting HGD and adenocarcinoma. The ability to grade dysplasia and differentiate intestinal metaplasia from nonintestinal metaplasia columnar-lined esophagus was also demonstrated. Diagnostic classification was based on objective measurement of the biochemical profile of different tissue types. The potential for combination ERS and narrow-band imaging was also demonstrated.LIMITATIONS:
Measurements were taken from ex vivo tissue.CONCLUSION:
ERS enables rapid, accurate, objective diagnosis of superficial esophageal disease (metaplasia, dysplasia, intramucosal cancer) in clinically applicable time scales.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Análise Espectral Raman
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Esôfago de Barrett
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Neoplasias Esofágicas
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Adenocarcinoma
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Esofagoscopia
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Esôfago
Tipo de estudo:
Diagnostic_studies
/
Screening_studies
Limite:
Humans
Idioma:
En
Revista:
Gastrointest Endosc
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Reino Unido