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Clin Cancer Res. 2009 May 1;15(9):3110-7. doi: 10.1158/1078-0432.CCR-08-2880. Epub 2009 Apr 21.

Rectal mucosal microvascular blood supply increase is associated with colonic neoplasia.

Author information

1
Biomedical Engineering Department, Northwestern University, IL, USA. a-gomes@northwestern.edu

Abstract

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.

PMID:
19383816
PMCID:
PMC2745222
DOI:
10.1158/1078-0432.CCR-08-2880
[Indexed for MEDLINE]
Free PMC Article

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