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Detection of adenocarcinoma in Barrett's oesophagus by means of laser induced fluorescence

von Holstein, C. S; Nilsson, A. M. K; Andersson-Engels, Stefan LU ; Willen, R; Walther, B and Svanberg, Katarina LU (1996) In Gut 39(5). p.711-716
Abstract
Patients-Seven patients with Barrett's metaplastic epithelium and oesophageal adenocarcinoma were investigated by means of laser induced fluorescence after low dose intravenous injection (0 . 35 mg/kg bw) of Photofrin (QLT, Vancouver, Canada). Laser induced fluorescence measurements were performed immediately after resection of the oesophagus. Methods-Laser induced fluorescence spectra were recorded from 15-30 locations in each surgical specimen from normal mucosa, Barrett's epithelium, and tumour tissue. Histological examination was performed on each location to correlate the fluorescence spectral characteristics with histological status of the epithelium (normal, metaplastic or malignant). Measurements were also performed during... (More)
Patients-Seven patients with Barrett's metaplastic epithelium and oesophageal adenocarcinoma were investigated by means of laser induced fluorescence after low dose intravenous injection (0 . 35 mg/kg bw) of Photofrin (QLT, Vancouver, Canada). Laser induced fluorescence measurements were performed immediately after resection of the oesophagus. Methods-Laser induced fluorescence spectra were recorded from 15-30 locations in each surgical specimen from normal mucosa, Barrett's epithelium, and tumour tissue. Histological examination was performed on each location to correlate the fluorescence spectral characteristics with histological status of the epithelium (normal, metaplastic or malignant). Measurements were also performed during endoscopy in five patients to test the applicability of the method in a clinical setting. Fluorescence spectra were recorded and evaluated at characteristic wavelengths, and biopsy specimens were collected. Fluorescence ratios were calculated as the quotient of Photofrin fluorescence divided by autofluorescence. Results-The mean (SD) fluorescence ratio values were 0 . 10 (0 . 058) for normal oesophageal mucosa, 0 . 16 (0 . 073) for normal gastric mucosa, 0 . 205 (0 . 17) for Barrett's epithelium with moderate dysplasia, 0 . 79 (0 . 54) for severe dysplasia, and 0 . 78 (0 . 56) for adenocarcinoma. The highest fluorescence ratios were obtained for adenocarcinoma tissue, which could generally be distinguished from all nonmalignant tissue. Metaplastic Barrett's epithelium also yielded higher fluorescence ratios than did normal mucosa. Conclusions-The results suggest that the technique can be used during endoscopy for real time tissue characterisation in the oesophagus, as an aid in detecting malignant transformation not macroscopisally apparent at endoscopy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Gut
volume
39
issue
5
pages
711 - 716
publisher
BMJ Publishing Group
external identifiers
  • Scopus:0030478985
ISSN
1468-3288
DOI
10.1136/gut.39.5.711
language
English
LU publication?
yes
id
e32a0820-df17-419d-a180-0fc29c24fbf4 (old id 2258407)
date added to LUP
2012-02-20 21:23:25
date last changed
2016-10-13 04:30:05
@misc{e32a0820-df17-419d-a180-0fc29c24fbf4,
  abstract     = {Patients-Seven patients with Barrett's metaplastic epithelium and oesophageal adenocarcinoma were investigated by means of laser induced fluorescence after low dose intravenous injection (0 . 35 mg/kg bw) of Photofrin (QLT, Vancouver, Canada). Laser induced fluorescence measurements were performed immediately after resection of the oesophagus. Methods-Laser induced fluorescence spectra were recorded from 15-30 locations in each surgical specimen from normal mucosa, Barrett's epithelium, and tumour tissue. Histological examination was performed on each location to correlate the fluorescence spectral characteristics with histological status of the epithelium (normal, metaplastic or malignant). Measurements were also performed during endoscopy in five patients to test the applicability of the method in a clinical setting. Fluorescence spectra were recorded and evaluated at characteristic wavelengths, and biopsy specimens were collected. Fluorescence ratios were calculated as the quotient of Photofrin fluorescence divided by autofluorescence. Results-The mean (SD) fluorescence ratio values were 0 . 10 (0 . 058) for normal oesophageal mucosa, 0 . 16 (0 . 073) for normal gastric mucosa, 0 . 205 (0 . 17) for Barrett's epithelium with moderate dysplasia, 0 . 79 (0 . 54) for severe dysplasia, and 0 . 78 (0 . 56) for adenocarcinoma. The highest fluorescence ratios were obtained for adenocarcinoma tissue, which could generally be distinguished from all nonmalignant tissue. Metaplastic Barrett's epithelium also yielded higher fluorescence ratios than did normal mucosa. Conclusions-The results suggest that the technique can be used during endoscopy for real time tissue characterisation in the oesophagus, as an aid in detecting malignant transformation not macroscopisally apparent at endoscopy.},
  author       = {von Holstein, C. S and Nilsson, A. M. K and Andersson-Engels, Stefan and Willen, R and Walther, B and Svanberg, Katarina},
  issn         = {1468-3288},
  language     = {eng},
  number       = {5},
  pages        = {711--716},
  publisher    = {ARRAY(0xa5a0bd0)},
  series       = {Gut},
  title        = {Detection of adenocarcinoma in Barrett's oesophagus by means of laser induced fluorescence},
  url          = {http://dx.doi.org/10.1136/gut.39.5.711},
  volume       = {39},
  year         = {1996},
}