• We are sorry, but NCBI web applications do not support your browser and may not function properly. More information
Logo of gutGutCurrent TOCInstructions to authors
Gut. Nov 1996; 39(5): 711–716.
PMCID: PMC1383396

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

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 macroscopically apparent at endoscopy.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Spechler SJ, Goyal RK. Barrett's esophagus. N Engl J Med. 1986 Aug 7;315(6):362–371. [PubMed]
  • Cameron AJ, Ott BJ, Payne WS. The incidence of adenocarcinoma in columnar-lined (Barrett's) esophagus. N Engl J Med. 1985 Oct 3;313(14):857–859. [PubMed]
  • Hameeteman W, Tytgat GN, Houthoff HJ, van den Tweel JG. Barrett's esophagus: development of dysplasia and adenocarcinoma. Gastroenterology. 1989 May;96(5 Pt 1):1249–1256. [PubMed]
  • Hansson LE, Sparén P, Nyrén O. Increasing incidence of both major histological types of esophageal carcinomas among men in Sweden. Int J Cancer. 1993 May 28;54(3):402–407. [PubMed]
  • Pera M, Cameron AJ, Trastek VF, Carpenter HA, Zinsmeister AR. Increasing incidence of adenocarcinoma of the esophagus and esophagogastric junction. Gastroenterology. 1993 Feb;104(2):510–513. [PubMed]
  • Skinner DB, Walther BC, Riddell RH, Schmidt H, Iascone C, DeMeester TR. Barrett's esophagus. Comparison of benign and malignant cases. Ann Surg. 1983 Oct;198(4):554–565. [PMC free article] [PubMed]
  • Sjogren RW, Jr, Johnson LF. Barrett's esophagus: a review. Am J Med. 1983 Feb;74(2):313–321. [PubMed]
  • Johansson J, Johnsson F, Walther B, Willén R, Staël von Holstein C, Zilling T. Adenocarcinoma in the distal esophagus with and without Barrett esophagus. Differences in symptoms and survival rates. Arch Surg. 1996 Jul;131(7):708–713. [PubMed]
  • Robertson CS, Mayberry JF, Nicholson DA, James PD, Atkinson M. Value of endoscopic surveillance in the detection of neoplastic change in Barrett's oesophagus. Br J Surg. 1988 Aug;75(8):760–763. [PubMed]
  • Schmidt HG, Riddell RH, Walther B, Skinner DB, Riemann JF. Dysplasia in Barrett's esophagus. J Cancer Res Clin Oncol. 1985;110(2):145–152. [PubMed]
  • Miros M, Kerlin P, Walker N. Only patients with dysplasia progress to adenocarcinoma in Barrett's oesophagus. Gut. 1991 Dec;32(12):1441–1446. [PMC free article] [PubMed]
  • Tytgat GN. Does endoscopic surveillance in esophageal columnar metaplasia (Barrett's esophagus) have any real value? Endoscopy. 1995 Jan;27(1):19–26. [PubMed]
  • Reid BJ, Weinstein WM, Lewin KJ, Haggitt RC, VanDeventer G, DenBesten L, Rubin CE. Endoscopic biopsy can detect high-grade dysplasia or early adenocarcinoma in Barrett's esophagus without grossly recognizable neoplastic lesions. Gastroenterology. 1988 Jan;94(1):81–90. [PubMed]
  • Levine DS, Haggitt RC, Blount PL, Rabinovitch PS, Rusch VW, Reid BJ. An endoscopic biopsy protocol can differentiate high-grade dysplasia from early adenocarcinoma in Barrett's esophagus. Gastroenterology. 1993 Jul;105(1):40–50. [PubMed]
  • Glasgold R, Glasgold M, Savage H, Pinto J, Alfano R, Schantz S. Tissue autofluorescence as an intermediate endpoint in NMBA-induced esophageal carcinogenesis. Cancer Lett. 1994 Jul 15;82(1):33–41. [PubMed]
  • Kapadia CR, Cutruzzola FW, O'Brien KM, Stetz ML, Enriquez R, Deckelbaum LI. Laser-induced fluorescence spectroscopy of human colonic mucosa. Detection of adenomatous transformation. Gastroenterology. 1990 Jul;99(1):150–157. [PubMed]
  • Vo-Dinh T, Panjehpour M, Overholt BF, Farris C, Buckley FP, 3rd, Sneed R. In vivo cancer diagnosis of the esophagus using differential normalized fluorescence (DNF) indices. Lasers Surg Med. 1995;16(1):41–47. [PubMed]
  • Baert L, Berg R, Van Damme B, D'Hallewin MA, Johansson J, Svanberg K, Svanberg S. Clinical fluorescence diagnosis of human bladder carcinoma following low-dose Photofrin injection. Urology. 1993 Apr;41(4):322–330. [PubMed]
  • Lam S, Palcic B, McLean D, Hung J, Korbelik M, Profio AE. Detection of early lung cancer using low dose Photofrin II. Chest. 1990 Feb;97(2):333–337. [PubMed]

Articles from Gut are provided here courtesy of BMJ Group

Formats:

Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...

Links

  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    MedGen
    Related information in MedGen
  • PubMed
    PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...