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Nat Med. 2008 Apr;14(4):454-8. doi: 10.1038/nm1692. Epub 2008 Mar 16.

Detection of colonic dysplasia in vivo using a targeted heptapeptide and confocal microendoscopy.

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  • 1Department of Pediatrics, Radiology and Microbiology & Immunology, Stanford University School of Medicine, 318 Campus Dr., Rm. E-150, Stanford, California 94305, USA.

Erratum in

  • Nat Med. 2008 May;14(5):585. Hsiung, Pei-Lei [corrected to Hsiung, Pei-Lin].


A combination of targeted probes and new imaging technologies provides a powerful set of tools with the potential to improve the early detection of cancer. To develop a probe for detecting colon cancer, we screened phage display peptide libraries against fresh human colonic adenomas for high-affinity ligands with preferential binding to premalignant tissue. We identified a specific heptapeptide sequence, VRPMPLQ, which we synthesized, conjugated with fluorescein and tested in patients undergoing colonoscopy. We imaged topically administered peptide using a fluorescence confocal microendoscope delivered through the instrument channel of a standard colonoscope. In vivo images were acquired at 12 frames per second with 50-microm working distance and 2.5-microm (transverse) and 20-microm (axial) resolution. The fluorescein-conjugated peptide bound more strongly to dysplastic colonocytes than to adjacent normal cells with 81% sensitivity and 82% specificity. This methodology represents a promising diagnostic imaging approach for the early detection of colorectal cancer and potentially of other epithelial malignancies.

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