No abstract

No abstract

The incidence of Barrett's oesophagus and oesophageal adenocarcinoma is increasing in Western countries. The outcome for patients with oesophageal cancer is extremely poor with only 15.1% of patients surviving for 5 years. The dismal outcome is largely due to late diagnosis which eliminates many patients from effective treatment.Oesophageal adenocarcinoma is often preceded by the development of dysplasia in a segment of Barrett's oesophagus. With the current surveillance strategies, it is extremely difficult to not only visualise areas of dysplasia, but also to accurately identify their morphological and architectural changes during histopathological diagnosis. Consensus statements recommend mucosal resection for dysplastic change in the oesophagus, thereby, preventing the development of adenocarcinoma. This strategy requires improved diagnostic tools that can reliably distinguish patients with dysplasia.Years of research have looked at a variety of different modalities that may aid with the current dilemma of difficulties in diagnosing dysplasia. This review looks at the modalities under development and analyses their advantages and the part they may well play in the future. It also looks at the future avenues that could be explored to aid in the understanding of the disease and to improve the outcomes.

than oesophageal cancer (0.735 vs. 0.900, p < 0.001). Inflammatory scores in GOJ cancers were lower than in gastric cancer and higher than in oesophageal cancer. Conclusion This study provides direct evidence for marked differences in the gastric mucosal phenotype in the patients with oesophageal versus gastric non-cardia cancer, with the former being healthy and uninflamed, but the latter atrophic and inflamed. The background gastric mucosa of GOJ cancer supported them being two distinct aetiologies, one group resembling oesophageal adenocarcinoma and other gastric non-cardia cancer. Disclosure of Interest None Declared. Introduction During last three decades, global incidence of oesophageal adenocarcinoma has increased more rapidly than any other cancer. A concurrent reduction in the incidence of gastric cancer has been reported from some populations. We aimed to examine the geographical pattern of oesophageal adenocarcinoma versus gastric non-cardia cancer across the world where reliable cancer registry data were available. Methods Data were abstracted from "Cancer Incidence in Five Continents" Volume 10. Oesophageal and gastric cancers were selected based on ICD-10 codes C15 and C16, respectively. Oesophageal adenocarcinomas were identified by ICD-O morphology codes. Datasets reporting >500 cases for total gastric cancer and >100 for total oesophageal cancer were selected. We examined correlation between age-standardised Incidence rates (ASR) of oesophageal adenocarcinoma and non-cardia gastric cancer using Spearman's non-parametric correlation coefficient (CC). We also allocated cardia cancers into oesophageal and non-cardia gastric adenocarcinoma categories based on gender ratio for oesophageal adenocarcinoma and non-cardia gastric cancer in each dataset. Results Out of 424 datasets from 290 cancer registries, 206 datasets covering 40 countries met the selection criteria. There was a strong inverse correlation between oesophageal adenocarcinoma and gastric non-cardia cancer in males (CC= -0.768, p < 0.001) and females (CC = -0.705, p < 0.001). After dividing cardia cancer into two subtypes with potentially oesophageal or gastric origin and adding them to original oesophageal adenocarcinoma or gastric non-cardia groups, the inverse correlation remained strong in males (CC= -0.660, p < 0.001) and females (CC= -0.536, p < 0.001). Oesophageal adenocarcinoma only showed a rise when incidence of non-cardia gastric cancer fell below 9/100,000 person-years for males and 4.5/100,000 person-years for females. Conclusion This cross-sectional study is consistent with a common underlying factor predisposing to non-cardia gastric cancer and protecting from oesophageal adenocarcinoma, such as H. pylori atrophic gastritis. If this is the case, then the incidence of non-cardia gastric cancer would need to fall to substantially lower levels than currently seen in Far Eastern populations before any rise in oesophageal adenocarcinoma would be apparent. PTU-165 WORLDWIDE EPIDEMIOLOGICAL EVIDENCE SUPPORTS

IntroductionRaman spectroscopy has been shown to accurately classify tissue pathology in a variety of conditions and organ systems. Much of this work has been performed using Raman microspectrometers on tissue sections.Despite the demonstrated potential as an accurate cancer diagnostic tool, Raman spectroscopy (RS) is yet to be adopted by the clinic for histopathology reviews. The Stratified Medicine through Advanced Raman Technologies (SMART) consortium has begun to address some of the hurdles (e.g. tissue sample preparation, data collection, pre-processing and transferability) in its adoption for cancer diagnosis. SMART is a multicentre industry-academic collaboration with the aim of developing a pathology platform for advanced diagnosis, using developments in hardware and software. Renishaw’s Streamline™ Raman technology enables collection of Raman spectral much faster without compromising signal to noise.This study aims to assess the ability of this technique to accurately classify tissue pathology, using an oesophageal model.MethodsSpecimens were collected from patients with Barrett’s oesophagus (BO), dysplasia and adenocarcinoma, and snap frozen in liquid nitrogen. 8μm tissue sections were prepared onto calcium fluoride slides, with contiguous sections stained with haematoxylin and eosin (H&E) for histological comparison. Raman spectra were collected across homogeneous regions of tissue pathology, using Streamline™ acquisitions of 60 seconds/line, at 1.1μm spatial resolution.ResultsAdvanced multivariate statistical analysis tools were used to develop pathology classification models, which were then tested using leave-one-out cross-validation. Each sample was then classified using a ‘voting classification’ for all pixels from one sample. The sensitivity and specificity of this pathology classification model using Raman Spectroscopy to discriminate dysplasia/adenocarcinoma from Barrett’s oesophagus produced sensitivity and specificities >80%.ConclusionBy combining multivariate statistical analysis with Streamline™ Raman acquisition of spectral data, we have demonstrated good sensitivities and specificities. This study illustrates the potential of non-invasive rapid Raman spectral mapping measurements and development of a robust and validated oesophageal classification model that are able to classify tissue pathology.Disclosure of InterestNone Declared