Current Problems in Surgery: Gastric Cancer

Clark, Clancy J.; Thirlby, Richard C.; Picozzi, Vicent; Schembre, Drew; Cummings, Felicia P.; Lin, Eugene C.

doi:10.1067/j.cpsurg.2006.06.003

Cited by 80 publications

(64 citation statements)

References 235 publications

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“…is critical to reducing the mortality rates of the patients. 2,3 However, the identification and localization of precancer and early flat cancerous lesions in the esophagus and gastric can be challenging for clinicians as conventional white-light reflectance (WLR) endoscopy heavily relies on visual identification of gross morphological tissue changes, resulting in poor diagnostic accuracy. In recent years, optical imaging methods, such as autofluorescence imaging (AFI) technique capable of detecting the changes of endogenous fluorophores and morphological architectures of tissue, and the narrow-band imaging (NBI) technique which enhances visualization of irregular mucosal and vascular patterns, have shown promising diagnostic potential for in vivo detection of preneoplastic and early neoplastic lesions at endoscopy.…”

Section: Introductionmentioning

confidence: 99%

Characterizing variability in in vivo Raman spectra of different anatomical locations in the upper gastrointestinal tract toward cancer detection

et al. 2011

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Abstract. Raman spectroscopy is an optical vibrational technology capable of probing biomolecular changes of tissue associated with cancer transformation. This study aimed to characterize in vivo Raman spectroscopic properties of tissues belonging to different anatomical regions in the upper gastrointestinal (GI) tract and explore the implications for early detection of neoplastic lesions during clinical gastroscopy. A novel fiber-optic Raman endoscopy technique was utilized for real-time in vivo tissue Raman measurements of normal esophageal (distal, middle, and proximal), gastric (antrum, body, and cardia) as well as cancerous esophagous and gastric tissues from 107 patients who underwent endoscopic examinations. The non-negativity-constrained least squares minimization coupled with a reference database of Raman active biochemicals (i.e., actin, histones, collagen, DNA, and triolein) was employed for semiquantitative biomolecular modeling of tissue constituents in the upper GI. A total of 1189 in vivo Raman spectra were acquired from different locations in the upper GI. The Raman spectra among the distal, middle, and proximal sites of the esophagus showed no significant interanatomical variability. The interanatomical variability of Raman spectra among normal gastric tissue (antrum, body, and cardia) was subtle compared to cancerous tissue transformation, whereas biomolecular modeling revealed significant differences between the two organs, particularly in the gastroesophageal junction associated with proteins, DNA, and lipids. Cancerous tissues can be identified across interanatomical regions with accuracies of 89.3% [sensitivity of 92.6% (162/175); specificity of 88.6% (665/751)], and of 94.7% [sensitivity of 90.9% (30/33); specificity of 93.9% (216/230)] in the gastric and esophagus, respectively, using partial least squares-discriminant analysis together with the leave-one tissue site-out, cross validation. This work demonstrates that Raman endoscopy technique has promising clinical potential for real-time, in vivo diagnosis and detection of malignancies in the upper GI at the molecular level. C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

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Section: Introductionmentioning

confidence: 99%

Characterizing variability in in vivo Raman spectra of different anatomical locations in the upper gastrointestinal tract toward cancer detection

et al. 2011

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“…1 Early diagnosis and localization with appropriate curative treatments ͑e.g., endoscopic submucosal dissection and gastrectomy͒ is critical to decreasing mortality. 2 However, identification of early cancer and precancer can be difficult, as conventional white-light reflectance ͑WLR͒ endoscopy heavily relies on visual identification of morphological tissue changes. Thus, subtle changes of gastric precancer ͑i.e., dysplasia͒ and early cancer may not be apparent, limiting diagnostic accuracy.…”

Section: Introductionmentioning

confidence: 99%

“…Positive endoscopic biopsy is the standard criterion for gastric precancer and cancer diagnosis, but it is invasive and impractical for screening highrisk patients who may have multiple suspicious lesions. 1,2 Very recently, narrow-band imaging ͑NBI͒ that enhances visualization of irregular mucosal and vascular patterns has shown promise for improving in vivo diagnosis of intraepithelial neoplastic lesions in gastric tissue. 3 Although the NBI technique provides good detection sensitivities, this wide-field endoscopic imaging modality still suffers from moderate diagnostic specificity due to the deficiency of revealing specific biochemical information of tissue.…”

Section: Introductionmentioning

confidence: 99%

In vivo early diagnosis of gastric dysplasia using narrow-band image-guided Raman endoscopy

et al. 2010

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Abstract. We first report on the implementation of a novel narrowband image-guided Raman endoscopy technique for in vivo diagnosis of gastric dysplasia. High-quality in vivo Raman spectra can be acquired from normal and dysplastic gastric mucosal tissue within 0.5 sec under narrow-band image ͑NBI͒ guidance at gastroscopy. Significant differences are observed in in vivo Raman spectra between normal ͑n =54͒ and dysplastic ͑n =18͒ gastric tissue from 30 gastric patients, particularly in the spectral ranges of 825 to 950, 1000 to 1100, 1250 to 1500, and 1600 to 1800 cm −1 , which primarily contain signals related to proteins, nucleic acids, and lipids. The multivariate analysis ͓i.e., principal components analysis ͑PCA͒ and linear discriminant analysis ͑LDA͔͒, together with the leave-one tissue siteout, cross validation on in vivo gastric Raman spectra yields a diagnostic sensitivity of 94.4% ͑17/ 18͒ and specificity of 96.3% ͑52/ 54͒ for distinction of gastric dysplastic tissue. This study suggests that narrowband image-guided Raman endoscopy associated with PCA-LDA diagnostic algorithms has potential for the noninvasive, in vivo early diagnosis and detection of gastric precancer during clinical gastroscopic examination.

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“…Gastric cancer is currently the fourth most common malignancy, and also the second leading cause of cancer deaths in humans worldwide (Axon, 2006;Clark et al, 2006). In Singapore, despite a falling incidence rate, gastric cancer still remains the fourth most common cancer (Teh et al, 2002).…”

mentioning

confidence: 99%

“…Many of these patients will die mainly because of nodal and metastatic disease present at the time of initial diagnosis. Early detection and localisation with immediate removal and treatment of premalignant lesions (e.g., dysplasia) (Clark et al, 2006) is crucial to improving patients' survival. However, early identification of dysplasia in the stomach can be very difficult to detect by conventional diagnostic methods such as white-light endoscope, as the white-light endoscopy heavily relies on the visual observation of gross morphological changes of pathologic tissues, leading to a poor diagnostic accuracy.…”

mentioning

confidence: 99%

Diagnostic potential of near-infrared Raman spectroscopy in the stomach: differentiating dysplasia from normal tissue

et al. 2008

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Raman spectroscopy is a molecular vibrational spectroscopic technique that is capable of optically probing the biomolecular changes associated with diseased transformation. The purpose of this study was to explore near-infrared (NIR) Raman spectroscopy for identifying dysplasia from normal gastric mucosa tissue. A rapid-acquisition dispersive-type NIR Raman system was utilised for tissue Raman spectroscopic measurements at 785 nm laser excitation. A total of 76 gastric tissue samples obtained from 44 patients who underwent endoscopy investigation or gastrectomy operation were used in this study. The histopathological examinations showed that 55 tissue specimens were normal and 21 were dysplasia. Both the empirical approach and multivariate statistical techniques, including principal components analysis (PCA), and linear discriminant analysis (LDA), together with the leave-one-sample-out crossvalidation method, were employed to develop effective diagnostic algorithms for classification of Raman spectra between normal and dysplastic gastric tissues. High-quality Raman spectra in the range of 800 -1800 cm À1 can be acquired from gastric tissue within 5 s. There are specific spectral differences in Raman spectra between normal and dysplasia tissue, particularly in the spectral ranges of 1200 -1500 cm À1 and 1600 -1800 cm À1 , which contained signals related to amide III and amide I of proteins, CH 3 CH 2 twisting of proteins/nucleic acids, and the C ¼ C stretching mode of phospholipids, respectively. The empirical diagnostic algorithm based on the ratio of the Raman peak intensity at 875 cm À1 to the peak intensity at 1450 cm À1 gave the diagnostic sensitivity of 85.7% and specificity of 80.0%, whereas the diagnostic algorithms based on PCA-LDA yielded the diagnostic sensitivity of 95.2% and specificity 90.9% for separating dysplasia from normal gastric tissue. Receiver operating characteristic (ROC) curves further confirmed that the most effective diagnostic algorithm can be derived from the PCA-LDA technique. Therefore, NIR Raman spectroscopy in conjunction with multivariate statistical technique has potential for rapid diagnosis of dysplasia in the stomach based on the optical evaluation of spectral features of biomolecules.

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Current Problems in Surgery: Gastric Cancer

Cited by 80 publications

References 235 publications

Characterizing variability in in vivo Raman spectra of different anatomical locations in the upper gastrointestinal tract toward cancer detection

Characterizing variability in in vivo Raman spectra of different anatomical locations in the upper gastrointestinal tract toward cancer detection

In vivo early diagnosis of gastric dysplasia using narrow-band image-guided Raman endoscopy

Diagnostic potential of near-infrared Raman spectroscopy in the stomach: differentiating dysplasia from normal tissue

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