Evaluation of microvascular density in Barrett's associated neoplasia

Konda, Vani J.; Hart, John; Shang, Lin; Tretiakova, Maria; Gordon, Ilyssa O.; Campbell, Lucas; Kulkarni, Anirudh; Bissonnette, Marc; Seewald, Stefan; Waxman, Irving

doi:10.1038/modpathol.2012.146

Cited by 15 publications

(13 citation statements)

References 18 publications

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“…Szafranowski et al reported a significant increase in microvessel density identified with CD34 and CD105 in laryngeal cancer and dysplasia when compared to the healthy control group [10]. Prior research on microvessel density in intraepithelial lesions of the oesophagus and cervix confirmed an increased vessel number associated with the transformation from intraepithelial lesions to invasive cancers [11, 12]. CD31 and CD34 are most commonly utilised as endothelial markers in the literature.…”

Section: Discussionmentioning

confidence: 99%

Microvascular density and hypoxia-inducible factor in intraepithelial vocal fold lesions

Rzepakowska

Žůrek

Grzybowski

et al. 2019

Eur Arch Otorhinolaryngol

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ObjectiveThe promotion of neovascularisation is a crucial aspect of carcinogenesis. The study evaluates the microvascular density (MVD) and expression of hypoxia-induced factor (HIF-1α) in hypertrophic vocal fold (VF) lesions of different histopathological states including non-dysplastic, low-grade, high-grade dysplasia and invasive glottic cancer.Materials and methodsHistological specimens collected from patients diagnosed and treated in a single centre with different histological grades were immunohistochemically stained with CD31, CD34 and HIF-1α. Of the total number of 77 analysed VF specimens, 20 were non-dysplastic, 20 had low-grade dysplasia, 17 high-grade dysplasia and 20 were invasive cancers.ResultsThe highest mean value for MVD evaluated with expression of CD31 (MVD CD31) was 21.23 ± 14.46 and identified in the low-grade dysplasia group. The average MVD CD31 was 13.74 ± 5.56 and 20.11 ± 9.28 in the high-grade dysplasia and invasive cancer group, respectively. The highest MVD evaluated with CD34 (MVD CD34) was revealed for invasive cancer 35.64 ± 17.21. The MVD CD34 was higher for low-grade than in high-grade dysplasia (25.87 ± 12.30 vs 24.65 ± 15.92, respectively). The expression of HIF-1α was strong or very strong in 60% of non-dysplastic lesions, 100% of low-grade dysplasia cases, 53% of high-grade dysplasia cases and 50% of invasive cancer cases. The comparison of MVD CD31 with MVD CD34 revealed a strong positive correlation (ρ value 0.727). The comparison of both MVD CD31 and MVD CD34 with HIF-1α resulted in no linear relationship (ρ value of 0.143 and 0.165, respectively).ConclusionThe stage of low-grade dysplasia in intraepithelial vocal fold lesions is related to significant advancement of angiogenesis together with the highest hypoxia level.Electronic supplementary materialThe online version of this article (10.1007/s00405-019-05355-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Microvascular density and hypoxia-inducible factor in intraepithelial vocal fold lesions

Rzepakowska

Žůrek

Grzybowski

et al. 2019

Eur Arch Otorhinolaryngol

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“…An increase in microvascular density also has been described across the metaplasia- dysplasia-carcinoma sequence, potentially contributing to the observed phenomenon. 22 Histologic studies also have described dilated ducts and glands that are surrounded, compressed, and deformed by a fibrotic lamina propria. 20,21 These cystic structures are thought to arise from compression of their glandular outlets by the collagen-rich tissue or by proliferating dysplastic cells.…”

Section: Discussionmentioning

confidence: 99%

Comparative diagnostic performance of volumetric laser endomicroscopy and confocal laser endomicroscopy in the detection of dysplasia associated with Barrett’s esophagus

Leggett

Gorospe

Chan

et al. 2016

Gastrointestinal Endoscopy

113

123

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Background and Aims Probe-based confocal laser endomicroscopy (pCLE) and volumetric laser endomicroscopy (VLE) (also known as frequency domain optical coherence tomography) are advanced endoscopic imaging modalities that may be useful in the diagnosis of dysplasia associated with Barrett’s esophagus (BE). We performed pCLE examination in ex-vivo EMR specimens and compared the diagnostic performance of using the current VLE scoring index (previously established as OCT-SI) and a novel VLE diagnostic algorithm (VLE-DA) for the detection of dysplasia. Methods A total of 27 patients with BE enrolled in a surveillance program at a tertiary-care center underwent 50 clinically indicated EMRs that were imaged with VLE and pCLE and classified into neoplastic (N = 34; high-grade dysplasia, intramucosal adenocarcinoma) and nonneoplastic (N = 16; low-grade dysplasia, nondysplastic BE), based on histology. Image datasets (VLE, N = 50; pCLE, N = 50) were rated by 3 gastroenterologists trained in the established diagnostic criteria for each imaging modality as well as a new diagnostic algorithm for VLE derived from a training set that demonstrated association of specific VLE features with neoplasia. Sensitivity, specificity, and diagnostic accuracy were assessed for each imaging modality and diagnostic criteria. Results The sensitivity, specificity, and diagnostic accuracy of pCLE for detection of BE dysplasia was 76% (95% confidence interval [CI], 59–88), 79% (95% CI, 53–92), and 77% (95% CI, 72–82), respectively. The optimal diagnostic performance of OCT-SI showed a sensitivity of 70% (95% CI, 52–84), specificity of 60% (95% CI, 36–79), and diagnostic accuracy of 67%; (95% CI, 58–78). The use of the novel VLE-DA showed a sensitivity of 86% (95% CI, 69–96), specificity of 88% (95% CI, 60–99), and diagnostic accuracy of 87% (95% CI, 86–88). The diagnostic accuracy of using the new VLE-DA criteria was significantly superior to the current OCT-SI (P < .01). Conclusion The use of a new VLE-DA showed enhanced diagnostic performance for detecting BE dysplasia ex vivo compared with the current OCT-SI. Further validation of this algorithm in vivo is warranted.

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“…Increased microvessel density in the progression from NDBE to LGD and HGD was recently reported based on ex vivo pathology specimens 12 . Narrow band imaging (NBI) 13, 14 and confocal laser endomicroscopy (CLE) 15, 16 were used to investigate microvascular changes as a potential marker for dysplasia.…”

Section: Introductionmentioning

confidence: 81%

Endoscopic optical coherence tomography angiography microvascular features associated with dysplasia in Barrett's esophagus (with video)

Lee

Ahsen

Liang

et al. 2017

Gastrointestinal Endoscopy

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Background and Aims Angiogenesis is associated with neoplastic progression of Barrett’s esophagus (BE). Volumetric optical coherence tomography angiography (OCTA) visualizes subsurface microvasculature without exogenous contrast agents. We investigated the association of OCTA microvascular features with low-grade dysplasia (LGD) and high-grade dysplasia (HGD). Methods Fifty-two patients undergoing BE surveillance or endoscopic eradication therapies for dysplasia were imaged using volumetric OCTA and corresponding histological diagnoses obtained, to yield 97 data sets (non-dysplastic BE (NDBE): N=74; LGD: N=10; HGD: N=13). After evaluating OCTA image quality, 54 datasets (NDBE: N=35; LGD: N=8; HGD: N=11) from 32 patients were used to develop a training and reading protocol. The association of abnormal vessel branching and heterogeneous vessel size with LGD/HGD, and a regular honeycomb vessel pattern with NDBE was investigated. Results Blinded OCTA reading of 41 OCTA datasets (NDBE: N=27; LGD: N=7; HGD: N=7) was performed by readers with various levels of OCT/OCTA experience including 3 OCT trainees, one gastroenterologist, and 2 gastroenterology fellows. Among the six readers, OCTA features of abnormal vessel branching and heterogeneous vessel size had an overall 94% sensitivity (95% CI, 89–99) and 69% specificity (95% CI, 62–76) for differentiating LGD/HGD vs. NDBE with a mean reading time of 45 seconds per data set and moderate (kappa: 0.58) interobserver agreement. Conclusions Volumetric en face OCTA imaging enables rapid examination of depth resolved microvascular features with near-microscopic resolution. OCTA can visualize microvascular features associated with LGD/HGD with high accuracy, which motivates new technological advances as well as future studies investigating the diagnostic performance of OCTA.

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Evaluation of microvascular density in Barrett's associated neoplasia

Cited by 15 publications

References 18 publications

Microvascular density and hypoxia-inducible factor in intraepithelial vocal fold lesions

Microvascular density and hypoxia-inducible factor in intraepithelial vocal fold lesions

Comparative diagnostic performance of volumetric laser endomicroscopy and confocal laser endomicroscopy in the detection of dysplasia associated with Barrett’s esophagus

Endoscopic optical coherence tomography angiography microvascular features associated with dysplasia in Barrett's esophagus (with video)

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