Document Detail


Rectal mucosal microvascular blood supply increase is associated with colonic neoplasia.
MedLine Citation:
PMID:  19383816     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Endoscopic examination has proven effective in both detecting and preventing colorectal cancer; however, only about a quarter of eligible patients undergo screening. Even if the compliance rate increased, limited endoscopic capacity and cost would be prohibitive. There is a need for an accurate method to target colonoscopy to those most at risk of harboring colonic neoplasia. Exploiting field carcinogenesis seems to be a promising avenue. Our group recently reported that an early increase in blood supply (EIBS) is a reliable marker of field carcinogenesis in experimental models. We now investigate whether in situ detection of EIBS in the rectum can predict neoplasia elsewhere in the colon.
EXPERIMENTAL DESIGN: We developed a novel polarization-gated spectroscopy fiber-optic probe that allows depth-selective interrogation of microvascular blood content. Using the probe, we examined the blood content in vivo from the rectal mucosa of 216 patients undergoing screening colonoscopy.
RESULTS: Microvascular blood content was increased by approximately 50% in the endoscopically normal rectal mucosa of patients harboring advanced adenomas when compared with neoplasia-free patients irrespective of lesion location. Demographic factors and nonneoplastic lesions did not confound this observation. Logistic regression using mucosal oxyhemoglobin concentration and patient age resulted in a sensitivity of 83%, a specificity of 82%, and an area under the receiver operating characteristic curve of 0.88 for the detection of advanced adenomas.
CONCLUSIONS: Increased microvascular blood supply in the normal rectal mucosa is associated with the presence of clinically significant neoplasia elsewhere in the colon, supporting the development of rectal EIBS as a colon cancer risk-stratification tool.
Authors:
Andrew J Gomes; Hemant K Roy; Vladimir Turzhitsky; Young Kim; Jeremy D Rogers; Sarah Ruderman; Valentina Stoyneva; Michael J Goldberg; Laura K Bianchi; Eugene Yen; Alexey Kromine; Mohammed Jameel; Vadim Backman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2009-04-21
Journal Detail:
Title:  Clinical cancer research : an official journal of the American Association for Cancer Research     Volume:  15     ISSN:  1078-0432     ISO Abbreviation:  Clin. Cancer Res.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-05-01     Completed Date:  2009-06-22     Revised Date:  2014-09-15    
Medline Journal Info:
Nlm Unique ID:  9502500     Medline TA:  Clin Cancer Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3110-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adenoma / blood supply*,  diagnosis
Area Under Curve
Colonic Neoplasms / blood supply*,  diagnosis
Colonic Polyps / diagnosis
Endoscopy, Gastrointestinal
Female
Humans
Intestinal Mucosa / blood supply*
Male
Microcirculation
Middle Aged
Prognosis
Rectum / blood supply*,  pathology
Risk Factors
Tumor Markers, Biological*
Grant Support
ID/Acronym/Agency:
R01 CA109861/CA/NCI NIH HHS; R01 CA109861-04A1/CA/NCI NIH HHS; R01 CA112315/CA/NCI NIH HHS; R01 CA112315-04/CA/NCI NIH HHS; R01 CA118794/CA/NCI NIH HHS; R01 CA118794-02/CA/NCI NIH HHS; R01 CA128641/CA/NCI NIH HHS; R01 CA128641-02/CA/NCI NIH HHS; R01CA109861/CA/NCI NIH HHS; R01CA112315/CA/NCI NIH HHS; R01CA118794/CA/NCI NIH HHS; R01CA128641/CA/NCI NIH HHS; R42 CA130508/CA/NCI NIH HHS; R42 CA130508-02/CA/NCI NIH HHS; R42CA130508/CA/NCI NIH HHS; U01 CA111257/CA/NCI NIH HHS; U01 CA111257-05/CA/NCI NIH HHS; U01CA111257/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Tumor Markers, Biological
Comments/Corrections

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