Colorectal polyps: Targets for fluorescence-guided endoscopy to detect high-grade dysplasia and T1 colorectal cancer

被引：3

作者：

Dekkers, Nik ^{[1
,6
]}

Zonoobi, Elham ^{[2
]}

Dang, Hao ^{[1
]}

Warmerdam, Mats I. I. ^{[2
]}

Crobach, Stijn ^{[3
]}

Langers, Alexandra M. J. ^{[1
]}

van der Kraan, Jolein ^{[1
]}

Hilling, Denise E. E. ^{[2
,4
]}

Peeters, Koen C. M. J. ^{[2
]}

Holman, Fabian A. A. ^{[2
]}

Vahrmeijer, Alexander L. L. ^{[2
]}

Sier, Cornelis F. M. ^{[2
,5
]}

Hardwick, James C. H. ^{[1
]}

Boonstra, Jurjen J. J. ^{[1
]}

机构：

[1] Leiden Univ, Med Ctr, Dept Gastroenterol & Hepatol, Leiden, Netherlands

[2] Leiden Univ, Med Ctr, Dept Surg, Leiden, Netherlands

[3] Leiden Univ, Med Ctr, Dept Pathol, Leiden, Netherlands

[4] Univ Med Ctr Rotterdam, Dept Surg Oncol & Gastrointestinal Surg, Rotterdam, Netherlands

[5] Percuros BV, Leiden, Netherlands

[6] Albinusdreef 2, NL-2333 ZA Leiden, Netherlands

来源：

UNITED EUROPEAN GASTROENTEROLOGY JOURNAL | 2023年 / 11卷 / 03期

基金：

欧盟地平线“2020”;

关键词：

advance; biomarkers; colorectal cancer; colorectal polyps; CRC; dysplasia; endoscopy; fluorescence; resection; target; CARCINOEMBRYONIC ANTIGEN; INTRAOPERATIVE DETECTION; OPTICAL DIAGNOSIS; EXPRESSION; CARCINOMA; BIOMARKER; SGM-101; COLON;

D O I：

10.1002/ueg2.12375

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

BackgroundDifferentiating high-grade dysplasia (HGD) and T1 colorectal cancer (T1CRC) from low-grade dysplasia (LGD) in colorectal polyps can be challenging. Incorrect recognition of HGD or T1CRC foci can lead to a need for additional treatment after local resection, which might not have been necessary if it was recognized correctly. Tumor-targeted fluorescence-guided endoscopy might help to improve recognition. ObjectiveSelecting the most suitable HGD and T1CRC-specific imaging target from a panel of well-established biomarkers: carcinoembryonic antigen (CEA), c-mesenchymal-epithelial transition factor (c-MET), epithelial cell adhesion molecule (EpCAM), folate receptor alpha (FR alpha), and integrin alpha-v beta-6 (alpha v beta 6). MethodsEn bloc resection specimens of colorectal polyps harboring HGD or T1CRC were selected. Immunohistochemistry on paraffin sections was used to determine the biomarker expression in normal epithelium, LGD, HGD, and T1CRC (scores of 0-12). The differential expression in HGD-T1CRC components compared to surrounding LGD and normal components was assessed, just as the sensitivity and specificity of each marker. Results60 specimens were included (21 HGD, 39 T1CRC). Positive expression (score >1) of HGD-T1CRC components was found in 73.3%, 78.3%, and 100% of cases for CEA, c-MET, and EpCAM, respectively, and in <40% for FR alpha and alpha v beta 6. Negative expression (score 0-1) of the LGD component occurred more frequently for CEA (66.1%) than c-MET (31.6%) and EpCAM (0%). The differential expression in the HGD-T1CRC component compared to the surrounding LGD component was found for CEA in 66.7%, for c-MET in 43.1%, for EpCAM in 17.2%, for FR alpha in 22.4%, and for alpha v beta 6 in 15.5% of the cases. Moreover, CEA showed the highest combined sensitivity (65.0%) and specificity (75.0%) for the detection of an HGD-T1CRC component in colorectal polyps. ConclusionOf the tested targets, CEA appears the most suitable to specifically detect HGD and T1 cancer foci in colorectal polyps. An in vivo study using tumor-targeted fluorescence-guided endoscopy should confirm these findings.

引用

页码：282 / 292

页数：11

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