Colorectal polyps: Targets for fluorescence‐guided endoscopy to detect high‐grade dysplasia and T1 colorectal cancer

Background Differentiating high‐grade dysplasia (HGD) and T1 colorectal cancer (T1CRC) from low‐grade dysplasia (LGD) in colorectal polyps can be challenging. Incorrect recognition of HGD or T1CRC foci can lead to a need for additional treatment after local resection, which might not have been neces...

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Published in:United European gastroenterology journal 2023-04, Vol.11 (3), p.282-292
Main Authors: Dekkers, Nik, Zonoobi, Elham, Dang, Hao, Warmerdam, Mats I., Crobach, Stijn, Langers, Alexandra M. J., Kraan, Jolein, Hilling, Denise E., Peeters, Koen C. M. J., Holman, Fabian A., Vahrmeijer, Alexander L., Sier, Cornelis F. M., Hardwick, James C. H., Boonstra, Jurjen J.
Format: Article
Language:English
Subjects:
advance
Antigens
biomarkers
Carcinoembryonic Antigen
Colonic Polyps - diagnosis
Colonic Polyps - surgery
Colorectal cancer
Colorectal Neoplasms - diagnosis
Colorectal Neoplasms - surgery
colorectal polyps
CRC
Decision making
dysplasia
Endoscopy
Endoscopy, Gastrointestinal
Epithelial Cell Adhesion Molecule
Ethics
fluorescence
Glycoproteins
Humans
Original
Pathology
Patients
Polyps
resection
target
Tumors
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Summary:Background Differentiating high‐grade dysplasia (HGD) and T1 colorectal cancer (T1CRC) from low‐grade dysplasia (LGD) in colorectal polyps can be challenging. Incorrect recognition of HGD or T1CRC foci can lead to a need for additional treatment after local resection, which might not have been necessary if it was recognized correctly. Tumor‐targeted fluorescence‐guided endoscopy might help to improve recognition. Objective Selecting the most suitable HGD and T1CRC‐specific imaging target from a panel of well‐established biomarkers: carcinoembryonic antigen (CEA), c‐mesenchymal‐epithelial transition factor (c‐MET), epithelial cell adhesion molecule (EpCAM), folate receptor alpha (FRα), and integrin alpha‐v beta‐6 (αvβ6). Methods En bloc resection specimens of colorectal polyps harboring HGD or T1CRC were selected. Immunohistochemistry on paraffin sections was used to determine the biomarker expression in normal epithelium, LGD, HGD, and T1CRC (scores of 0–12). The differential expression in HGD‐T1CRC components compared to surrounding LGD and normal components was assessed, just as the sensitivity and specificity of each marker. Results 60 specimens were included (21 HGD, 39 T1CRC). Positive expression (score >1) of HGD‐T1CRC components was found in 73.3%, 78.3%, and 100% of cases for CEA, c‐MET, and EpCAM, respectively, and in
ISSN:2050-6406
2050-6414
DOI:10.1002/ueg2.12375