Oxygen saturation imaging as a useful tool for visualizing the mode of action of photodynamic therapy for esophageal cancer

Suyama, Masayuki; Yoda, Yusuke; Yamamoto, Yoichi; Sunakawa, Hajime; Minamide, Tatsunori; Ikematsu, Hiroaki; Yano, Tomonori

doi:10.1016/j.vgie.2020.07.003

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“…10,[12][13][14][15][16][17] In superficial esophageal squamous cell carcinoma (SESCC), it has been reported that the expression of hypoxia markers is higher than that in non-neoplasia [20][21][22] and lower than that in advanced ESCC. 10,[12][13][14][15][16][17] Furthermore, oxygen saturation endoscopic imaging (OXEI, FUJIFILM, Tokyo) collaboratively developed by our group, for visualizing the oxygen status of digestive tract lesions as a color map in real time [23][24][25] has previously revealed that the oxygen saturation (StO 2 ) in esophageal neoplasia was significantly lower than that in non-neoplasia. 23 This finding is consistent with previous reports relating to the expression of hypoxia markers.…”

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confidence: 99%

Immunohistochemistry and oxygen saturation endoscopic imaging reveal hypoxia in submucosal invasive esophageal squamous cell carcinoma

et al. 2023

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BackgroundHypoxic microenvironment is prominent in advanced esophageal squamous cell carcinoma (ESCC). However, it is unclear whether ESCC becomes hypoxic when it remains in the mucosal layer or as it invades the submucosal layer. We aimed to investigate whether intramucosal (Tis‐T1a) or submucosal invasive (T1b) ESCC becomes hypoxic using endoscopic submucosal dissection samples.MethodsWe evaluated the expression of hypoxia markers including hypoxia inducible factor 1α (HIF‐1α), carbonic anhydrase IX (CAIX), and glucose transporter 1 (GLUT1) by H‐score and vessel density by microvessel count (MVC) and microvessel density (MVD) for CD31 and α‐smooth muscle actin (α‐SMA) with immunohistochemical staining (n = 109). Further, we quantified oxygen saturation (StO2) with oxygen saturation endoscopic imaging (OXEI) (n = 16) and compared them to non‐neoplasia controls, Tis‐T1a, and T1b.ResultsIn Tis‐T1a, cccIX (13.0 vs. 0.290, p < 0.001) and GLUT1 (199 vs. 37.6, p < 0.001) were significantly increased. Similarly, median MVC (22.7/mm2 vs. 14.2/mm2, p < 0.001) and MVD (0.991% vs. 0.478%, p < 0.001) were markedly augmented. Additionally, in T1b, the mean expression of HIF‐1α (16.0 vs. 4.95, p < 0.001), CAIX (15.7 vs. 0.290, p < 0.001), and GLUT1 (177 vs. 37.6, p < 0.001) were significantly heightened, and median MVC (24.8/mm2 vs. 14.2/mm2, p < 0.001) and MVD (1.51% vs. 0.478%, p < 0.001) were markedly higher. Furthermore, OXEI revealed that median StO2 was significantly lower in T1b than in non‐neoplasia (54% vs. 61.5%, p = 0.00131) and tended to be lower in T1b than in Tis‐T1a (54% vs. 62%, p = 0.0606).ConclusionThese results suggest that ESCC becomes hypoxic even at an early stage, and is especially prominent in T1b.

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