Towards Colonscopy-free Colon Cancer Screening by Enhanced Light Backscattering

通过增强光后向散射实现免结肠镜检查结肠癌筛查

• 批准号: 7676799
• 负责人: Vadim Backman
• 金额: $ 25.6万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-17 至 2010-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7676799
• 关键词: Aberrant crypt foci; Address; Age; American; Animals; Apoptosis; Architecture; Area; Azoxymethane; Benefits and Risks; Biological; Biological Assay; Biological Markers; Biomedical Engineering; Cancer Etiology; Cancer Patient; Cessation of life; Clinical Medicine; Clinical Research; Colon; Colon Carcinoma; Colonic Adenoma; Colonic Neoplasms; Colonoscopy; Colorectal Cancer; Complication; Costs and Benefits; Data; Detection; Development; Diagnosis; Distal; Double-Blind Method; Early Diagnosis; Ensure; Epigenetic Process; Epithelium; Event; Fiber Optics; Fingerprint; Flexible fiberoptic sigmoidoscopy; Future; Gastroenterologist; Genetic; Genus Cola; Goals; Grant; Healthcare; Histologic; Hospitals; Human; Imaging Techniques; In Situ; Individual; Intestines; Knowledge; Laboratories; Lead; Lesion; Light; Malignant Neoplasms; Molecular; Mucous Membrane; Neoplasms; Optics; Patient Noncompliance; Patient Recruitments; Patients; Performance; Phase; Plague; Population; Populations at Risk; Predictive Value; Preparation; Primary Care Physician; Procedures; Proliferation Marker; Prospective Studies; Publishing; Rectum; Research; Research Infrastructure; Research Personnel; Resolution; Resources; Risk; Risk Assessment; Screening procedure; Spectrum Analysis; Staging; Stratification; Submucosa; Techniques; Technology; Testing; Time; Tissues; Translational Research; Treatment Protocols; United States National Institutes of Health; Universities; Validation; Work; acronyms; adenoma; base; cancer prevention; clinical practice; colon carcinogenesis; colorectal cancer prevention; colorectal cancer screening; cost; design; fascinate; high risk; human data; in vivo; innovation; instrument; interest; light scattering; miniaturize; multidisciplinary; nano; nanoscale; neoplastic; novel; optical imaging; prevent; programs; prospective; prototype; rectal; tumor

DESCRIPTION (provided by applicant): This application addresses development of a novel non-invasive depth-resolved optical imaging technique, low-coherence enhanced backscattering spectroscopy (EBS), for colorectal cancer (CRC) screening. CRC remains the second leading cause of cancer death in the U.S. Although colonoscopy is remarkably effective in reducing CRC, screening the entire at-risk population (>60 million Americans over age 50) through colonoscopy is impossible for a variety of reasons including expense, patient reluctance and resource availability. Thus, targeting patients at the highest risk is crucial for designing efficacious and cost-effective CRC screening strategies. Many risk-stratification techniques exploit the "field effect" of colon carcinogenesis, the notion that the genetic/epigenetic alterations that lead to a tumor in one area should be detectable throughout the colon mucosa. Thus, detecting early events in the most readily accessible colonic mucosa (i.e. rectum) could lead to accurate long term risk assessment. However, technological limitations have, to date, stymied this approach. Our data demonstrate that depth-resolved EBS has the ability to detect the micro/nanoscale architectural consequences of the molecular changes in the "field effect" with unprecedented accuracy. This work builds upon our development, for the first time to the best of our knowledge, of EBS spectroscopy for highly sensitive sensing of depth-resolved changes in tissue microarchitecture. Our animal and pilot human studies indicate that EBS markers have performance superior to all conventional markers of CRC. Based on our preliminary data, we hypothesize that EBS interrogation of the rectal mucosa should allow accurate prediction of colonic neoplasia and hence need for colonoscopy. In order to develop EBS for CRC screening, we propose to develop an endoscopically compatible EBS probe and discover new EBS markers. These previous and novel EBS markers will be used to formulate prediction rules for both the presence and absence of neoplasia in 500 patients undergoing colonoscopy. This will then be validated in a prospective clinical study. In the future these spectral markers may be assayed with an EBS fiber-optic probe during a routine rectal examination without the need for bowel preparation, thus providing a practical and accurate means of determining the optimal CRC screening regimen, such as the need for colonoscopy.

描述（由申请人提供）：此申请解决了用于结直肠癌（CRC）筛查的新型非侵入性深度分解的光学成像技术，低相位的反向散射光谱（EBS）。 CRC仍然是美国癌症死亡的第二大原因，尽管结肠镜检查在减少CRC方面非常有效，由于多种原因，包括费用，患者不情愿和资源可用性，不可能通过结肠镜检查筛查整个高危​​人群（> 6000万美国人）。因此，针对风险最高的患者对于设计有效且具有成本效益的CRC筛查策略至关重要。许多风险分层技术利用了结肠癌的“场效应”，即在整个结肠粘膜中应检测到导致一个区域肿瘤的遗传/表观遗传学改变的观点。因此，检测最容易获得的结肠粘膜（即直肠）中的早期事件可能会导致准确的长期风险评估。但是，迄今为止，技术局限性阻碍了这种方法。我们的数据表明，深度分辨的EB具有以前所未有的精度检测“场效应”中分子变化的微/纳米级结构后果。据我们所知，这项工作是基于我们的发展，这是对EBS光谱法的首次发展，以高度敏感地感知组织微体系结构的深度分辨变化。我们的动物和试点人类研究表明，EBS标记的性能优于CRC的所有常规标记。根据我们的初步数据，我们假设对直肠粘膜的EBS询问应允许准确预测结肠肿瘤，因此需要进行结肠镜检查。为了开发用于CRC筛查的EBS，我们建议开发内镜下兼容的EBS探测器并发现新的EBS标记。这些先前和新颖的EBS标记将用于制定500名接受结肠镜检查患者的肿瘤的预测规则。然后，这将在一项前瞻性临床研究中得到验证。将来，这些频谱标记物可以在常规直肠检查过程中使用EBS纤维探针测定，而无需肠子制备，因此提供了确定最佳CRC筛查方案的实用和准确方法，例如对结肠镜检查的需求。