| Rectal mucosal microvascular blood supply increase is associated with colonic neoplasia. | |
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MedLine Citation:
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PMID: 19383816 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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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:
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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:
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Created Date: 2009-05-01 Completed Date: 2009-06-22 Revised Date: 2011-08-01 |
Medline Journal Info:
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Nlm Unique ID: 9502500 Medline TA: Clin Cancer Res Country: United States |
Other Details:
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Languages: eng Pagination: 3110-7 Citation Subset: IM |
Affiliation:
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Biomedical Engineering Department, Northwestern University, IL, USA. a-gomes@northwestern.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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R01 CA109861-04A1/CA/NCI NIH HHS; R01 CA112315-04/CA/NCI NIH HHS; R01 CA118794-02/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 CA130508-02/CA/NCI NIH HHS; R42CA130508/CA/NCI NIH HHS; U01 CA111257-05/CA/NCI NIH HHS; U01CA111257/CA/NCI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Tumor Markers, Biological |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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