Endoscopic molecular imaging of early gastric cancer targeting transferrin receptor 1.

e23093 Background: Gastric cancer is primarily managed endoscopically by white light gastroscope with suboptimal diagnostic accuracy. Emerging optical imaging technologies possess great potential for improving diagnostic accuracy but currently lack imaging agents for molecular specificity. In this study, a novel ligand of transferrin receptor 1 (TfR1), human H-ferritin (HFn), was labeled with fluorescent agents to enable in vivo real-time imaging by confocal laser endomicroscopy (CLE). Methods: In vivo fluorescence imaging was performed in tumor-bearing mice from human gastric cancer cell lines using fluorescently labeled HFn nanoprobe. The HFn-FITC as molecular imaging agent was applied to the gastric cancer with confocal laser endomicroscopy (CLE) in fresh endoscopic submucosal dissection (ESD) of early gastric cancer. Results: Intravital imaging of gastric xenograft tumors revealed a specific tumor targeting effects of HFn-IRDye800CW, whereas no specific signal was observed in mice injected with free dye. An ex vivo experiment on human specimens using a rigid confocal probe showed positive fluorescent staining in ESD samples diagnosed as early gastric cancers. Our CLE evaluation correlated well with immunohistochemical findings. Conclusions: CLE can be used for in vivo, molecular analysis of early gastric cancer and to identify TfR1 expression in xenografts and human tissue samples. HFn-targeted molecular imaging could improve early detection of gastric cancer.

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In vivo molecular imaging of gastric cancer by targeting MG7 antigen with confocal laser endomicroscopy

Endoscopy ◽

10.1055/s-0032-1325762 ◽

2013 ◽

Vol 45 (02) ◽

pp. 79-85 ◽

Cited By ~ 26

Author(s):

Z. Li ◽

X. Zuo ◽

C. Li ◽

C. Zhou ◽

J. Liu ◽

...

Keyword(s):

Gastric Cancer ◽

Molecular Imaging ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser

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Sa1221 ENDOSCOPIC MOLECULAR IMAGING OF EARLY GASTRIC CANCER USING HUMAN HEAVY-CHAIN FERRITIN NANOPROBE UNDER CONFOCAL LASER ENDOMICROSCOPY

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2018.04.1422 ◽

2018 ◽

Vol 87 (6) ◽

pp. AB169-AB170

Author(s):

Yang Du ◽

Kelong Fan ◽

Hejun Zhang ◽

Shigang Ding ◽

Xiyun Yan ◽

...

Keyword(s):

Gastric Cancer ◽

Molecular Imaging ◽

Early Gastric Cancer ◽

Heavy Chain ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser

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In vivo molecular imaging of gastric cancer in human-murine xenograft models with confocal laser endomicroscopy using a tumor vascular homing peptide

Cancer Letters ◽

10.1016/j.canlet.2014.10.036 ◽

2015 ◽

Vol 356 (2) ◽

pp. 891-898 ◽

Cited By ~ 11

Author(s):

Lijuan Liu ◽

Jipeng Yin ◽

Changhao Liu ◽

Guofeng Guan ◽

Doufei Shi ◽

...

Keyword(s):

Gastric Cancer ◽

Molecular Imaging ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Xenograft Models ◽

Homing Peptide

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Utilizing fourth-generation endocytoscopy and the ‘enlarged nuclear sign’ for in vivo diagnosis of early gastric cancer

Endoscopy International Open ◽

10.1055/a-0957-2866 ◽

2019 ◽

Vol 07 (08) ◽

pp. E1002-E1007 ◽

Cited By ~ 2

Author(s):

Mary Raina Angeli Abad ◽

Haruhiro Inoue ◽

Haruo Ikeda ◽

Anastassios Manolakis ◽

Enrique Rodriguez de Santiago ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Diagnostic Accuracy ◽

Cancer Diagnosis ◽

Kappa Statistic ◽

Observer Agreement ◽

Fourth Generation ◽

Well Differentiated ◽

Sensitivity Specificity

Abstract Background and study aims Fourth-generation endocytoscopy is an ultra-high magnification endoscopic technique designed to provide excellent quality in vivo histologic assessment of gastrointestinal lesions. This study aims to evaluate the diagnostic accuracy of endocytoscopy in early gastric cancer diagnosis. Patients and methods A single-center, retrospective analysis of prospectively collected data from all gastric endocytoscopic examinations was conducted. Two expert endoscopists, blinded to white-light and narrow-band imaging findings as well as histopathologic diagnosis, independently reviewed and diagnosed all endocytoscopic images. A newly recognized “enlarged nuclear sign” was detected, and its implication in early gastric cancer diagnosis was evaluated. The diagnostic performance of fourth-generation endocytoscopy was assessed while using the gold standard histopathology as a reference. Results Forty-three patients (mean age±SD, 72.6 ± 12.1 years; 31 males) were enrolled. Based on histopathology, 23 had well-differentiated adenocarcinomas, four adenomas, and 16 non-neoplastic lesions. The sensitivity, specificity, and accuracy of fourth-generation endocytoscopy for gastric cancer diagnosis were 87.0 % (95 % CI: 67.9 – 95.5), 80.0 % (95 % CI: 58.4 – 91.9), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist A; and 91.3 % (95 % CI: 73.2 – 97.6), 75.0 % (95 % CI: 53.1 – 88.8), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist B. The inter-observer agreement, Kappa statistic = 0.71 (95 % CI: 0.50 – 0.93), was good. The sensitivity, specificity, and accuracy of the enlarged nuclear sign for early gastric cancer diagnosis were 87.0 % (95 % CI: 67.9 – 95.5), 95.0 % (95 % CI: 76.4 – 99.1), and 90.7 % (95 % CI: 78.4 – 96.3) by endoscopist A; and 82.6 % (95 % CI: 62.9 – 93.0), 85.0 % (95 % CI: 64.0 – 94.8), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist B. The inter-observer agreement, Kappa statistic = 0.68 (95 % CI: 0.51 – 0.89) was good. Conclusion: Fourth-generation endocytoscopy appears to aid in the diagnosis of early gastric cancer, particularly well-differentiated adenocarcinomas, due to its good diagnostic accuracy and identification of the “enlarged nuclear sign,” and deserves further evaluation in future studies.

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Confocal laser endomicroscopy under propofol‐based sedation for early gastric cancer and pre‐cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

BMC Anesthesiology ◽

10.1186/s12871-021-01312-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Lihua Chu ◽

Jialian Zhao ◽

Cheng Sheng ◽

Min Yue ◽

Feifei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Intestinal Metaplasia ◽

Retrospective Cohort ◽

Precancerous Lesions ◽

Characteristic Curve ◽

Intraepithelial Neoplasia ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Patient Cooperation

Abstract Background Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions. Methods A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed. Patients enrolled were allocated into the propofol-based sedated group (n = 126) and the un-sedated group (n = 100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines. Results The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95 % CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95 % CI: 0.80 to 0.97), P = 0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P = 0.0008 and P = 0.0001, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive endoscopic submucosal dissection (ESD) subsequently, and the misdiagnosis rate of CLE was 0 % in the sedated group and 27.59 % (95 % CI: 10.30–44.91 %) in the un-sedated group (P = 0.006). Conclusions Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions (intraepithelial neoplasia OR intestinal metaplasia).

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473 In Vivo Molecular Imaging Using Fluorescent Anti-TNF Antibodies and Confocal Laser Endomicroscopy Predicts Response to Anti-TNF Therapy in Crohn's Disease

Gastroenterology ◽

10.1016/s0016-5085(13)60317-0 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-85-S-86 ◽

Cited By ~ 4

Author(s):

Raja Atreya ◽

Helmut Neumann ◽

Clemens Neufert ◽

Maximilian J. Waldner ◽

Yurdagül Zopf ◽

...

Keyword(s):

Crohn’S Disease ◽

Molecular Imaging ◽

Crohn's Disease ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser

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Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnosing accuracy: a retrospective cohort study in China

10.21203/rs.3.rs-41225/v1 ◽

2020 ◽

Author(s):

Lihua Chu ◽

Jialian Zhao ◽

Cheng Sheng ◽

Min Yue ◽

Feifei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Retrospective Cohort ◽

Precancerous Lesions ◽

Characteristic Curve ◽

Intraepithelial Neoplasia ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Validity And Reliability ◽

Patient Cooperation

Abstract Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed.Patients enrolled were allocated into propofol-based sedated group (n=126) and un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnose and pathological diagnose. Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0084, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive ESD subsequently, and the misdiagnosis rate of CLE was 0 in sedated group and 27.59% in un-sedated group (P =0.006).Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions.

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Confocal laser endomicroscopy under propofol-based sedation for early gastric cancer and pre-cancerous lesions is associated with better diagnostic accuracy: a retrospective cohort study in China

10.21203/rs.3.rs-41225/v2 ◽

2020 ◽

Author(s):

Lihua Chu ◽

Jialian Zhao ◽

Cheng Sheng ◽

Min Yue ◽

Feifei Wang ◽

...

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Retrospective Cohort ◽

Precancerous Lesions ◽

Characteristic Curve ◽

Intraepithelial Neoplasia ◽

Confocal Laser Endomicroscopy ◽

Confocal Laser ◽

Validity And Reliability ◽

Patient Cooperation

Abstract Background: Confocal laser endomicroscopy (CLE) has advantages in detecting gastric neoplastic lesions, meanwhile it requires strict patient cooperation. Sedation could improve patient cooperation and quality of endoscopy. However, sedation is still not very popular in some resource-limited countries and regions. The purpose of this study was to compare propofol-based sedated versus un-sedated CLE in the value of diagnosing early gastric cancer (EGC) and precancerous lesions.Methods: A retrospective, cohort, single center study of 226 patients who underwent CLE between January 1, 2015 and December 31, 2017 was performed.Patients enrolled were allocated into the propofol-based sedated group (n=126) and the un-sedated group (n=100). The comparison of validity and reliability of CLE for identifying EGC and precancerous lesions between the two groups was performed through analyzing CLE diagnosis and pathological diagnosis. Reporting followed the STROBE guidelines.Results: The area under receiver operating characteristic curve (AUROC) of diagnosing EGC in the sedated group was 0.97 (95% CI: 0.95 to 0.99), which was higher than that in the un-sedated group (0.88 (95% CI: 0.80 to 0.97), P =0.0407). CLE with sedation performed better than without sedation in diagnosing intraepithelial neoplasia and intestinal metaplasia (P =0.0008 and P =0.0084, respectively). For patients considered as high-grade intraepithelial neoplasia or EGC by endoscopists, they would not get biopsy during CLE but receive endoscopic submucosal dissection (ESD) subsequently, and the misdiagnosis rate of CLE was 0% in the sedated group and 27.59% in the un-sedated group (P =0.006).Conclusion: Propofol based sedation was associated with improved diagnostic value of CLE for detecting EGC as well as precancerous lesions.

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