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Ruderman S, Eshein A, Valuckaite V, Dougherty U, Almoghrabi A, Gomes A, Singh A, Pabla B, Roy HK, Hart J, Bissonnette M, Konda V, Backman V. Early increase in blood supply (EIBS) is associated with tumor risk in the Azoxymethane model of colon cancer. BMC Cancer 2018; 18:814. [PMID: 30103733 PMCID: PMC6090821 DOI: 10.1186/s12885-018-4709-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 07/31/2018] [Indexed: 01/20/2023] Open
Abstract
Background The present study aimed to investigate the role of blood supply in early tumorigenesis in colorectal cancer. We leveraged the renin angiotensin system (RAS) to alter colonic blood supply and determine the effect on tumor initiation and progression. Methods To test the effect of blood supply on tumorigenesis, 53 male A/J mice were randomly assigned to one of three RAS modulation groups and one of two AOM treatments. The RAS modulation groups were I) water (RAS-unmodulated) as a control group, II) angiotensin-II and III) the angiotensin receptor blocker, Losartan. The mice in each group were then randomly split into either the saline control condition or the AOM-treated condition in which tumors were induced with a standard protocol of serial azoxymethane (AOM) injections. To monitor microvascular changes in the rectal mucosa during the study, we used confocal laser endomicroscopy (CLE) with FITC-Dextran for in-vivo imaging of vessels and polarization-gated spectroscopy (PGS) to quantify rectal hemoglobin concentration ([Hb]) and blood vessel radius (BVR). Results At 12 weeks post-AOM injections and before tumor formation, CLE images revealed many traditional hallmarks of angiogenesis including vessel dilation, loss of co-planarity, irregularity, and vessel sprouting in the pericryptal capillaries of the rectal mucosa in AOM-Water tumor bearing mice. PGS measurements at the same time-point showed increased rectal [Hb] and decreased BVR. At later time points, CLE images showed pronounced angiogenic features including irregular networks throughout the colon. Notably, the AOM-Losartan mice had significantly lower tumor multiplicity and did not exhibit the same angiogenic features observed with CLE, or the increase in [Hb] or decrease in BVR measured with PGS. The AOM-AngII mice did not have any significant trends. Conclusion In-vivo PGS measurements of rectal colonic blood supply as well as CLE imaging revealed angiogenic disruptions to the capillary network prior to tumor formation. Losartan demonstrated an effective way to mitigate the changes to blood supply during tumorigenesis and reduce tumor multiplicity. These effects can be used in future studies to understand the early vessel changes observed.
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Affiliation(s)
- Sarah Ruderman
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Adam Eshein
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Vesta Valuckaite
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Urszula Dougherty
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Anas Almoghrabi
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Andrew Gomes
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA
| | - Ajaypal Singh
- Department of Gastroenterology, Rush University, Chicago, IL, 60612, USA
| | - Baldeep Pabla
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Hemant K Roy
- Department of Gastroenterology, Boston Medical Center, Boston, MA, 02118, USA
| | - John Hart
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Marc Bissonnette
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Vani Konda
- Center for Endoscopic Research and Therapeutics, University of Chicago Medicine, Chicago, IL, 60637, USA
| | - Vadim Backman
- Department of Biomedical Engineering, Northwestern University, Evanston, IL, 60208, USA.
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Metabolic reprogramming of the premalignant colonic mucosa is an early event in carcinogenesis. Oncotarget 2017; 8:20543-20557. [PMID: 28423551 PMCID: PMC5400525 DOI: 10.18632/oncotarget.16129] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 02/27/2017] [Indexed: 12/31/2022] Open
Abstract
Background Colorectal cancer (CRC) is the second leading cause of cancer-related mortality in the United States. There is an increasing need for the identification of biomarkers of pre-malignant and early stage CRC to improve risk-stratification and screening recommendations. In this study, we investigated the possibility of metabolic and mitochondrial reprogramming early in the pre-malignant colorectal field. Methods Rectal biopsies were taken from 81 patients undergoing screening colonoscopy, and gene expression of metabolic and mitochondrial markers were assessed using real time quantitative PCR. Validation studies were performed in two different animal models of colon carcinogenesis: Pirc rats and AOM-treated rats. Results We found evidence of a Warburg effect in the normal-appearing rectal mucosa of patients harboring precancerous lesions elsewhere in the colon compared to control patients, with a significant increase in HIF1a, SLC2A1 (referred to as GLUT1), PKM2, and LDHA. We also found evidence of early mitochondrial changes in the colorectal field of patients harboring pre-cancerous lesions, with significantly increased mitochondrial gene expression of DRP1 (fission), OPA1 (fusion), PGC1-a (biogenesis), UCP2 (uncoupling) and mtND1 (copy number). Similar results were observed in the two different animal models. Conclusions These results demonstrate for the first time evidence of early Warburg-like metabolic changes as well as changes in mitochondrial function, dynamics and mtDNA copy number in endoscopically normal premalignant colorectal mucosal field. These findings provide an opportunity for the development of metabolic biomarkers that could be used for improving screening recommendations and risk-stratification. This also provides a potential target for novel chemopreventive strategies in the pre-malignant colorectal field.
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Sensitivity and Specificity of Fractal Analysis to Distinguish Between Healthy and Pathologic Rectal Mucosa Microvasculature Seen During Colonoscopy. Surg Laparosc Endosc Percutan Tech 2016; 26:358-363. [PMID: 27636146 DOI: 10.1097/sle.0000000000000321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Conventional endoscopy is limited by human capability to recognize and to differentiate pathology. Fractal analysis of blood vessels has been used in other organs, such as the retina, but never before to supplement colonoscopy. The aim of this study was to assess whether it is possible to differentiate between healthy and pathologic rectal mucosa using fractal analysis of the mucosal microvascular architecture seen during colonoscopic examination (Supplemental Digital Content 1, http://links.lww.com/SLE/A145). METHODS A total of 300 consecutive patients, 133 females and 167 males with a mean age of 49.1 (±11.3) years, undergoing endoscopy were included in the prospective cohort study. Colonoscopy of the sigmorectal region was performed, and then analyzed with computer-assisted image fractal analysis. RESULTS Fractal analysis of mucosal vasculature allowed for differentiation between healthy and pathologic rectal mucosa, as well as different pathologies (P<0.0001). The sensitivity of fractal analysis to diagnose rectal neoplasia was 92.8% to 96.4%, while the specificity was 91.9% to 98.5% depending on the fractal parameter. The sensitivity of fractal analysis to diagnose rectal colitis was 84.2% to 92.1%, while the specificity was 95.0% to 96.0%, depending on the fractal parameter. CONCLUSIONS Computer-assisted fractal analysis allows for differentiation between healthy and pathologic rectal mucosa, as well as between different mucosal pathologies, seen during colonoscopy. Fractal analysis improves the sensitivity and specificity of colonoscopy to aid in the diagnosis of neoplasia or colitis, and should be included in the screening and surveillance of these pathologies.
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Patel M, Gomes A, Ruderman S, Hardee D, Crespo S, Raimondo M, Woodward T, Backman V, Roy H, Wallace M. Polarization gating spectroscopy of normal-appearing duodenal mucosa to detect pancreatic cancer. Gastrointest Endosc 2014; 80:786-93.e1-2. [PMID: 24861243 PMCID: PMC4241379 DOI: 10.1016/j.gie.2014.03.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 03/18/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND According to the field effect theory, by detecting microvasculature changes such as early increase in blood supply (EIBS) in the surrounding tissue, neoplastic lesions can be identified from a distance. OBJECTIVE To determine the feasibility and efficacy of a fiberoptic probe containing novel polarization gating spectroscopy technology to identify patients with pancreatic adenocarcinoma (PAC) by the field effect theory. DESIGN Prospective cohort (pilot) study. SETTING Outpatient tertiary care center. PATIENTS Adult (≥ 18 years) patients undergoing EGD-EUS were screened. Patients with PAC were included in the "cancer" group and patients without PAC were included in the "control" group. We excluded patients with other known malignancies and gastroduodenal premalignant lesions. INTERVENTIONS AND MAIN OUTCOME MEASURES Spectroscopic measurements of EIBS variables, such as deoxyhemoglobin concentration (DHb) and mean blood vessel radius (BVR), were obtained from 5 periampullary locations. The Mann-Whitney rank sum test was used for the statistical analysis (P ≤ .05). RESULTS Fourteen patients (mean age 72 years, 79% male) in the cancer group and 15 patients (mean age 63 years, 60% male) in the control group were included in the final analysis. At the ampullary site, both DHb (P = .001) and BVR (P = .03) were higher in PAC patients than in the control subjects. The DHb alone (92% sensitivity, 86% specificity) or in combination with BVR (92% sensitivity, 79% specificity) can differentiate PAC from control subjects with high accuracy. LIMITATIONS Small sample size, unmatched control subjects. CONCLUSIONS Spectroscopic measurements of EIBS by fiberoptic probes are feasible. Preliminary evidence suggests that in vivo measurement of normal-appearing duodenal tissue can differentiate PAC patients from a distance with high accuracy.
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Affiliation(s)
- Mihir Patel
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Andrew Gomes
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Sarah Ruderman
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Darla Hardee
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Sergio Crespo
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Massimo Raimondo
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Timothy Woodward
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
| | - Vadim Backman
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois
| | - Hemant Roy
- Department of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
| | - Michael Wallace
- Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida
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Cruz MD, Wali RK, Bianchi LK, Radosevich AJ, Crawford SE, Jepeal L, Goldberg MJ, Weinstein J, Momi N, Roy P, Calderwood AH, Backman V, Roy HK. Colonic mucosal fatty acid synthase as an early biomarker for colorectal neoplasia: modulation by obesity and gender. Cancer Epidemiol Biomarkers Prev 2014; 23:2413-21. [PMID: 25155760 DOI: 10.1158/1055-9965.epi-14-0026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND We have previously reported that colonic pericryptal microvascular blood flow is augmented in the premalignant colonic epithelium, highlighting the increased metabolic demand of the proliferative epithelium as a marker of field carcinogenesis. However, its molecular basis is unexplored. In this study, we assessed the expression of a regulator of the "lipogenic switch," fatty acid synthase (FASN), in early colon carcinogenesis for its potential biomarker utility for concurrent neoplasia. METHODS FASN expression (IHC) in the colonic epithelium from azoxymethane and polyposis in rat colon (Pirc) models of colorectal cancer was studied. FASN mRNA expression from endoscopically normal rectal mucosa was evaluated and correlated with colonoscopic findings (pathologic confirmation of neoplasia). RESULTS FASN expression progressively increased from premalignant to malignant stage in the azoxymethane model (1.9- to 2.5-fold; P < 0.0001) and was also higher in the adenomas compared with adjacent uninvolved mucosa (1.8- to 3.4-fold; P < 0.001) in the Pirc model. Furthermore, FASN was significantly overexpressed in rectal biopsies from patients harboring adenomas compared with those with no adenomas. These effects were accentuated in male (∼2-fold) and obese patients (1.4-fold compared with those with body mass index < 30). Overall, the performance of rectal FASN was excellent (AUROC of 0.81). CONCLUSIONS FASN is altered in the premalignant colonic mucosa and may serve as a marker for colonic neoplasia present elsewhere. The enhanced effects in men and obesity may have implications for identifying patient subgroups at risk for early-onset neoplasia. IMPACT These findings support the role of rectal FASN expression as a reliable biomarker of colonic neoplasia.
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Affiliation(s)
- Mart Dela Cruz
- Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
| | - Ramesh K Wali
- Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts.
| | - Laura K Bianchi
- Department of Medicine, NorthShore University HealthSystem, Evanston, Illinois
| | - Andrew J Radosevich
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois
| | - Susan E Crawford
- Department of Pathology, St. Louis University, St. Louis, Missouri
| | - Lisa Jepeal
- Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
| | - Michael J Goldberg
- Department of Medicine, NorthShore University HealthSystem, Evanston, Illinois
| | - Jaclyn Weinstein
- Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
| | - Navneet Momi
- Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
| | - Priya Roy
- Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
| | - Audrey H Calderwood
- Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
| | - Vadim Backman
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois
| | - Hemant K Roy
- Section of Gastroenterology, Boston University Medical Center, Boston, Massachusetts
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6
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Yi J, Radosevich AJ, Stypula-Cyrus Y, Mutyal NN, Azarin SM, Horcher E, Goldberg MJ, Bianchi LK, Bajaj S, Roy HK, Backman V. Spatially resolved optical and ultrastructural properties of colorectal and pancreatic field carcinogenesis observed by inverse spectroscopic optical coherence tomography. JOURNAL OF BIOMEDICAL OPTICS 2014; 19:36013. [PMID: 24643530 PMCID: PMC4019430 DOI: 10.1117/1.jbo.19.3.036013] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 02/13/2014] [Accepted: 02/17/2014] [Indexed: 05/18/2023]
Abstract
Field carcinogenesis is the initial stage of cancer progression. Understanding field carcinogenesis is valuable for both cancer biology and clinical medicine. Here, we used inverse spectroscopic optical coherence tomography to study colorectal cancer (CRC) and pancreatic cancer (PC) field carcinogenesis. Depth-resolved optical and ultrastructural properties of the mucosa were quantified from histologically normal rectal biopsies from patients with and without colon adenomas (n=85) as well as from histologically normal peri-ampullary duodenal biopsies from patients with and without PC (n=22). Changes in the epithelium and stroma in CRC field carcinogenesis were separately quantified. In both compartments, optical and ultra-structural alterations were consistent. Optical alterations included lower backscattering (μb) and reduced scattering (μs') coefficients and higher anisotropy factor g. Ultrastructurally pronounced alterations were observed at length scales up to ∼450 nm, with the shape of the mass density correlation function having a higher shape factor D, thus implying a shift to larger length scales. Similar alterations were found in the PC field carcinogenesis despite the difference in genetic pathways and etiologies. We further verified that the chromatin clumping in epithelial cells and collagen cross-linking caused D to increase in vitro and could be among the mechanisms responsible for the observed changes in epithelium and stroma, respectively.
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Affiliation(s)
- Ji Yi
- Northwestern University, Department of Biomedical Engineering, 2145 Sheridan Road, Evanston, Illinois 60208
| | - Andrew J. Radosevich
- Northwestern University, Department of Biomedical Engineering, 2145 Sheridan Road, Evanston, Illinois 60208
| | - Yolanda Stypula-Cyrus
- Northwestern University, Department of Biomedical Engineering, 2145 Sheridan Road, Evanston, Illinois 60208
| | - Nikhil N. Mutyal
- Northwestern University, Department of Biomedical Engineering, 2145 Sheridan Road, Evanston, Illinois 60208
| | - Samira Michelle Azarin
- Northwestern University, Department of Biomedical Engineering, 2145 Sheridan Road, Evanston, Illinois 60208
| | - Elizabeth Horcher
- Northwestern University, Department of Biomedical Engineering, 2145 Sheridan Road, Evanston, Illinois 60208
| | - Michael J. Goldberg
- NorthShore University Health Systems, Department of Internal Medicine, Evanston, Illinois 60201
| | - Laura K. Bianchi
- NorthShore University Health Systems, Department of Internal Medicine, Evanston, Illinois 60201
| | - Shailesh Bajaj
- NorthShore University Health Systems, Department of Internal Medicine, Evanston, Illinois 60201
| | - Hemant K. Roy
- Boston Medical Center, Department of Medicine, Boston, Massachusetts 02118
| | - Vadim Backman
- Northwestern University, Department of Biomedical Engineering, 2145 Sheridan Road, Evanston, Illinois 60208
- Address all correspondence to: Vadim Backman, E-mail:
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Backman V, Roy HK. Advances in biophotonics detection of field carcinogenesis for colon cancer risk stratification. J Cancer 2013; 4:251-61. [PMID: 23459690 PMCID: PMC3584838 DOI: 10.7150/jca.5838] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 02/11/2013] [Indexed: 02/06/2023] Open
Abstract
The process of neoplastic transformation of the colon involves a progression through hyperproliferative epithelium through the aberrant crypt foci→small adenoma→large adenoma→invasive cancer→metastatic disease. These are orchestrated by sequential genetic and epigenetic events which provide the underpinnings of cellular alterations such as early induction in proliferation/suppression of apoptosis, along with the late stage increase in invasiveness. Colorectal cancer (CRC) averages 49-111 mutations per tumor encompassing 10-15 critical signaling pathways[1]. Accumulating such a high number of mutations requires a fertile mutational field, which is the hallmark of colon carcinogenesis. While genetic susceptibility to colorectal cancer is well-known, at least half of the risk is believed to be due to exogeneous factors (e.g., obesity, diet, exercise). Understanding these risk factors represents a promising mode of tailoring screening modality and intensity. However, previous attempts using these factors (i.e., NCI risk calculator) have only been modestly successful with an area under receiver operating characteristics (ROC) curve (AUC) of just 0.61. One of the most important concepts is that risk is the interaction between these genetic and environmental components and is driven by the variety of polymorphisms. Thus, predicting risk is difficult given the complexity. On the other hand, the colonic mucosa represents the end product of the complex interplay between these multiple factors. The power of field carcinogenesis is that it reflects this interplay between genetics and environment.
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Affiliation(s)
- Vadim Backman
- 1. Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
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Damania D, Roy HK, Subramanian H, Weinberg DS, Rex DK, Goldberg MJ, Muldoon J, Cherkezyan L, Zhu Y, Bianchi LK, Shah D, Pradhan P, Borkar M, Lynch H, Backman V. Nanocytology of rectal colonocytes to assess risk of colon cancer based on field cancerization. Cancer Res 2012; 72:2720-7. [PMID: 22491589 DOI: 10.1158/0008-5472.can-11-3807] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Developing a minimally invasive and cost-effective prescreening strategy for colon cancer is critical because of the impossibility of conducting colonoscopy on the entire at-risk population. The concept of field carcinogenesis, in which normal-appearing tissue away from a tumor has molecular and, consequently, nano-architectural abnormalities, offers one attractive approach to identify high-risk patients. In this study, we investigated whether the novel imaging technique partial wave spectroscopic (PWS) microscopy could risk-stratify patients harboring precancerous lesions of the colon, using an optically measured biomarker (L(d)) obtained from microscopically normal but nanoscopically altered cells. Rectal epithelial cells were examined from 146 patients, including 72 control patients, 14 patients with diminutive adenomas, 20 patients with nondiminutive/nonadvanced adenomas, 15 patients with advanced adenomas/high-grade dysplasia, 12 patients with genetic mutation leading to Lynch syndrome, and 13 patients with cancer. We found that the L(d) obtained from rectal colonocytes was well correlated with colon tumorigenicity in our patient cohort and in an independent validation set of 39 additional patients. Therefore, our findings suggest that PWS-measured L(d) is an accurate marker of field carcinogenesis. This approach provides a potential prescreening strategy for risk stratification before colonoscopy.
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Affiliation(s)
- Dhwanil Damania
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois, USA
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9
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Tiwari AK, Crawford SE, Radosevich A, Wali RK, Stypula Y, Kunte DP, Mutyal N, Ruderman S, Gomes A, Cornwell ML, De La Cruz M, Brasky J, Gibson TP, Backman V, Roy HK. Neo-angiogenesis and the premalignant micro-circulatory augmentation of early colon carcinogenesis. Cancer Lett 2011; 306:205-13. [PMID: 21493000 DOI: 10.1016/j.canlet.2011.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Revised: 03/07/2011] [Accepted: 03/11/2011] [Indexed: 12/23/2022]
Abstract
Spectroscopic techniques have demonstrated that in the microscopically normal mucosa, there is an increase in mucosal micro-circulation in patients harboring neoplasia elsewhere in the colon (i.e. marker of field carcinogenesis). However, the physiological and molecular basis of this early increase in blood supply (EIBS) has not been elucidated. We, therefore, investigated the microvessel density (MVD) and angiogenic gene expression in the premalignant colonic mucosa from the well-validated azoxymethane (AOM)-treated rat experimental model of colon carcinogenesis. Fisher 344 rats were treated with AOM (15 mg/kg i.p.) or saline and euthanized 14 weeks later (a time-point that precedes carcinoma development). Colon sections were studied for MVD via immunohistochemical assessment for CD31 and location was compared with optical assessment of mucosal hemoglobin with low-coherence enhanced backscattering spectroscopy (LEBS). Finally, we performed a pilot real-time PCR angiogenesis microarray (84 genes) from the microscopically normal colonic mucosa of AOM and age-matched saline treated rats. AOM treatment increased MVD in both the mucosa and submucosa of the rats (125% increase in mucosa; p<0.007, and 96% increase in submucosa; p<0.02) but the increase was most pronounced at the cryptal base consistent with the LEBS data showing maximal hemoglobin augmentation at 200-225 μm depth. Microarray analysis showed striking dysregulation of angiogenic and anti-angiogenic factors. We demonstrate, for the first time, that neo-angiogenesis occurs in the microscopically normal colonic mucosa and was accentuated at the bottom of the crypt. This finding has potential implications as a biomarker for risk-stratification and target for chemoprevention.
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Affiliation(s)
- Ashish K Tiwari
- Department of Medicine, NorthShore University HealthSystem, Evanston, IL, USA
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Liu Q. Role of optical spectroscopy using endogenous contrasts in clinical cancer diagnosis. World J Clin Oncol 2011; 2:50-63. [PMID: 21603314 PMCID: PMC3095461 DOI: 10.5306/wjco.v2.i1.50] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 10/17/2010] [Accepted: 10/24/2010] [Indexed: 02/06/2023] Open
Abstract
Optical spectroscopy has been intensively studied for cancer management in the past two decades. This review paper first introduces the background of optical spectroscopy for cancer management, which includes the advantages of optical techniques compared to other established techniques, the principle of optical spectroscopy and the typical setup of instrumentation. Then the recent progress in optical spectroscopy for cancer diagnosis in the following organs is reviewed: the brain, breast, cervix, lung, stomach, colon, prostate and the skin. Reviewed papers were selected from the PubMed database with keywords combining the terms of individual optical spectroscopy techniques and cancers. The primary focus is on the in vivo applications of optical spectroscopy in clinical studies. Ex vivo studies are also included for some organs to highlight special applications or when there are few in vivo results in the literature. Practical considerations of applying optical spectroscopy in clinical settings such as the speed, cost, complexity of operation, accuracy and clinical value are discussed. A few commercially available clinical instruments that are based on optical spectroscopy techniques are presented. Finally several technical challenges and standard issues are discussed and firm conclusions are made.
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Affiliation(s)
- Quan Liu
- Quan Liu, Division of Bioengineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, N1.3-B2-06, 70 Nanyang Drive, Singapore 637457, Singapore
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Backman V, Roy HK. Light-scattering technologies for field carcinogenesis detection: a modality for endoscopic prescreening. Gastroenterology 2011; 140:35-41. [PMID: 21078318 PMCID: PMC3319699 DOI: 10.1053/j.gastro.2010.11.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Colonoscopy has revolutionized colorectal cancer (CRC) screening resulting in a decrease in both CRC mortality and incidence. Despite this, CRC still ranks as the second leading cause of cancer deaths among Americans underscoring the need to both increase availability and accuracy of colonoscopy. The latter considerations provide the impetus for much of the current research into adjunctive imaging technologies. Recent advances in improving detection of dysplasia that have translated into clinical practice include high-definition scopes, narrow-band imaging, and chromo-endoscopy. Another major direction of research into improving endoscopy is determining histology of lesions in situ (“optical biopsy”) with confocal endomicroscopy, fluorescence and elastic scattering spectroscopy. All these techniques are of great promise in improving delivery of endoscopy but, to date, have not addressed the potentially more important hurdle associated with logistic challenges of providing accurate CRC screening for the entire at-risk population.
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Affiliation(s)
- Vadim Backman
- Biomedical Engineering Department, Northwestern University, Evanston, Illinois 60208, USA.
| | - Hemant K. Roy
- Section of Gastroenterology, NorthShore University HealthSystems, Evanston IL
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12
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Radosevich AJ, Turzhitsky VM, Mutyal NN, Rogers JD, Stoyneva V, Tiwari AK, De La Cruz M, Kunte DP, Wali RK, Roy HK, Backman V. Depth-resolved measurement of mucosal microvascular blood content using
low-coherence enhanced backscattering spectroscopy. BIOMEDICAL OPTICS EXPRESS 2010; 1:1196-1208. [PMID: 21258541 PMCID: PMC3018078 DOI: 10.1364/boe.1.001196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 10/10/2010] [Accepted: 10/17/2010] [Indexed: 05/04/2023]
Abstract
Low-coherence enhanced backscattering (LEBS) spectroscopy is a light scattering technique which uses partial spatial coherence broadband illumination to interrogate the optical properties at sub-diffusion length scales. In this work, we present a post-processing technique which isolates the hemoglobin concentration at different depths within a sample using a single spectroscopic LEBS measurement with a fixed spatial coherence of illumination. We verify the method with scattering (spectralon reflectance standard and polystyrene microspheres) and absorbing (hemoglobin) phantoms. We then demonstrate the relevance of this method for quantifying hemoglobin content as a function of depth within biological tissue using the azoxymethane treated animal model of colorectal cancer.
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Affiliation(s)
- Andrew J. Radosevich
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60208, USA
| | - Vladimir M. Turzhitsky
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60208, USA
| | - Nikhil N. Mutyal
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60208, USA
| | - Jeremy D. Rogers
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60208, USA
| | - Valentina Stoyneva
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60208, USA
| | - Ashish Kumar Tiwari
- Department of Gastroenterology, Northshore University Healthsystems, Evanston, Illinois 60201, USA
| | - Mart De La Cruz
- Department of Gastroenterology, Northshore University Healthsystems, Evanston, Illinois 60201, USA
| | - Dhananjay P. Kunte
- Department of Gastroenterology, Northshore University Healthsystems, Evanston, Illinois 60201, USA
| | - Ramesh K. Wali
- Department of Gastroenterology, Northshore University Healthsystems, Evanston, Illinois 60201, USA
| | - Hemant K. Roy
- Department of Gastroenterology, Northshore University Healthsystems, Evanston, Illinois 60201, USA
| | - Vadim Backman
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois 60208, USA
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