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8 maart 2016: Als aanvulling op onderstaand bericht hier enkele nieuwe studies met deze vorm van diagnose van beginnende slokdarmkanker. De abstracten plus referentielijsten staan onderaan artikel

Hier een algemene studie waarvan het volledige studierapport gratis is in te zien: Application of confocal laser endomicroscopy in the diagnosis and management of Barrett’s esophagus

en een studie met ratten waarvan het volledige studierapport ook gratis is in te zien, waarin er ook een stofje aan is toegevoegd die bepaalde receptoren activieert als het ware waardoor er nog meer is te zien, zie verderop in artikel foto van het verschil: Detection of fluorescent organic nanoparticles by confocal laser endomicroscopy in a rat model of Barrett's esophageal adenocarcinoma.

Je vraagt je toch af waarom dit soort opsporingstechnieken niet veel sneller gebruikt worden.

Het zou heel veel patienten behoeden voor belastende diagnose technieken en nog beter als er iets ontdekt wordt kan er veel sneller worden ingegrepen.

28 januari 2012: Bron: Mailonsunday

Engelse onderzoekers aan de Cambridge universiteit hebben een fluoriscerende keelspray ontwikkeld om slokdarmkanker vroeger op te sporen en beter te kunnen vaststellen waar de tumor zit en hoever deze is verspreid. De huidige methoden die worden gebruikt voor het opsporen en diagnosteren kunnen dermate onnauwkeurig zijn of te laat worden gedaan dat een deel van de patiënten een onnodige en te grote invasieve behandeling met inbegrip van verwijdering van hun slokdarm moeten ondergaan.

Nu hebben wetenschappers een fluoriscerende kleurstof spray ontwikkeld die zich hecht aan gezonde cellen in de slokdarm, maar die zich niet kan hechten aan kankercellen. Als deze spray wordt gebruikt geeft deze een duidelijke verwijzing naar de plaats waar de tumor zich ontwikkelt. Indien beginnende tumoren in deze fase worden gespot, kunnen de kankercellen worden verwijderd met een vorm van RFA - Radio Frequency Ablation.

Foto: het verschil tussen scan zonder fluoriscerend stofje en met!!!!

Hoofdonderzoeker dr. Rebecca Fitzgerald zegt: "De huidige methoden voor het screenen op slokdarmkanker zijn controversieel - ze zijn duur, ongemakkelijk voor de patiënt en zijn niet volledig accuraat. Onze techniek belicht de exacte positie van een zich ontwikkelende slokdarmkanker en hoe ver deze is verspreid. En geeft een nauwkeuriger beeld dan andere technieken.
Met deze methode hebben de onderzoekers al kunnen voorkomen bij enkele patiënten uit de studiegroep dat deze een ingrijpende operatie zouden moeten ondergaan.

De onderzoekers testten deze behandeling op 80 biopten van mensen met de ziekte van Barrett (reflux), een aandoening die het risico op slokdarmkanker verhoogd. En zij testten de methode bij vier patiënten met slokdarmkanker.
De onderzoekers zeggen dat de gebruikte kleurstof relatief goedkoop is en waarschijnlijk weinig bijwerkingen kan veroorzaken omdat het gebruik maakt van een soort van tarwekiemen eiwit dat voorkomt in onze normale voeding.
Deze kleurstof bindt aan glycanen - suiker-moleculen - op het oppervlak van cellen in de slokdarm en de onderzoekers voegen een fluorescerend label eraan toe om het groen op te laten lichten onder het licht van een specifieke golflengte.
Het geheel kan dan bekeken worden met behulp van een endoscoop.
De glycanen tonen precies aan waar al kleine veranderingen plaatsvinden in het weefsel. Veranderingen die met andere methoden nog niet worden getraceerd.

Voordat de spray kan worden gebruikt zullen er meerdere studies moeten worden gedaan bij grotere groepen patiënten, maar de onderzoekers verwachten dat binnen 5 jaar deze methode beschikbaar zal komen voor algemeen gebruik.

Klik hier als u de originele engelstalige tekst waarvan bovenstaande een vrije vertaling is wilt lezen.

There are several studies that have demonstrated reasonable diagnostic accuracy in patients undergoing surveillance for Barrett’s esophagus from tertiary academic medical centers.

Ann Gastroenterol. 2014; 27(3): 193–199.

PMCID: PMC4073013

Application of confocal laser endomicroscopy in the diagnosis and management of Barrett’s esophagus

Cadman L. Leggett and Emmanuel C. Gorospe

Author information ► Article notes ► Copyright and License information ►

This article has been cited by other articles in PMC.

Abstract

Confocal laser endomicroscopy is an advanced endoscopic imaging modality that can be used for the diagnosis of early mucosal dysplasia in various gastrointestinal conditions. It provides histology-like images at 1000-fold magnification. The technology offers potential advantages in the diagnosis of Barrett’s esophagus and early esophageal cancer due to the low yield of the current practice of surveillance endoscopy with biopsies. Confocal laser endomicroscopy has the potential to eliminate the need for biopsy, establish diagnosis and facilitate application of endoscopic therapy during the time of actual endoscopy. There are several studies that have demonstrated reasonable diagnostic accuracy in patients undergoing surveillance for Barrett’s esophagus from tertiary academic medical centers. However, the application of confocal laser endomicroscopy in routine clinical endoscopy is still in the process of refinement. Its role in the diagnosis and treatment of Barrett’s-associated dysplasia will continue to evolve with improvement in technology, criteria for diagnosis and experience among endoscopists in interpreting confocal imaging.

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the combination of NP platform and confocal laser endomicroscopy could play an important role for highlighting esophageal cancer conditions. This result supports the potential of this strategy as a targeted carrier for photoactive and bioactive molecules in esophageal cancer diagnosis and treatment.

Int J Nanomedicine. 2015; 10: 6811–6823.

Published online 2015 Oct 30. doi: 10.2147/IJN.S86640

PMCID: PMC4636176

Detection of fluorescent organic nanoparticles by confocal laser endomicroscopy in a rat model of Barrett’s esophageal adenocarcinoma

Elisa Dassie,^1,^2,^* Diletta Arcidiacono,^2,^3,^* Iga Wasiak,⁴ Nunzio Damiano,⁵ Luigi Dall’Olmo,⁶ Cinzia Giacometti,⁷ Sonia Facchin,³ Mauro Cassaro,⁷ Ennio Guido,⁸ Franca De Lazzari,⁸ Oriano Marin,^9,¹⁰ Tomasz Ciach,⁴ Suzanne Fery-Forgues,^11,¹² Alfredo Alberti,^1,² Giorgio Battaglia,¹³ and Stefano Realdon¹³

Author information ► Copyright and License information ►

Abstract

For many years, novel strategies for cancer detection and treatment using nanoparticles (NPs) have been developed. Esophageal adenocarcinoma is the sixth leading cause of cancer-related deaths in Western countries, and despite recent advances in early detection and treatment, its prognosis is still very poor. This study investigated the use of fluorescent organic NPs as potential diagnostic tool in an experimental in vivo model of Barrett’s esophageal adenocarcinoma. NPs were made of modified polysaccharides loaded with [4-(dicyanomethylene)-2-methyl-6-(4-dimethylaminostyryl)-4H-pyran] (DCM), a well-known fluorescent dye. The NP periphery might or might not be decorated with ASYNYDA peptide that has an affinity for esophageal cancer cells. Non-operated and operated rats in which gastroesophageal reflux was surgically induced received both types of NPs (NP-DCM and NP-DCM-ASYNYDA) by intravenous route. Localization of mucosal NPs was assessed in vivo by confocal laser endomicroscopy, a technique which enables a “real time” and in situ visualization of the tissue at a cellular level. After injection of NP-DCM and NP-DCM-ASYNYDA, fluorescence was observed in rats affected by esophageal cancer, whereas no signal was observed in control non-operated rats, or in rats with simple esophagitis or Barrett’s esophagus mucosa. Fluorescence was observable in vivo 30 minutes after the administration of NPs. Interestingly, NP-DCM-ASYNYDA induced strong fluorescence intensity 24 hours after administration. These observations suggested that NPs could reach the tumor cells, likely by enhanced permeability and retention effect, and the peptide ASYNYDA gave them high specificity for esophageal cancer cells. Thus, the combination of NP platform and confocal laser endomicroscopy could play an important role for highlighting esophageal cancer conditions. This result supports the potential of this strategy as a targeted carrier for photoactive and bioactive molecules in esophageal cancer diagnosis and treatment.

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slokdarmkanker, fluoriscerende spray, diagnostiek, ziekte van Barrett