<i>In vivo</i> pilot study into superficial microcirculatory characteristics of colorectal adenomas using novel high-resolution magnifying endoscopy with blue laser imaging

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Abstract

BACKGROUND

No studies have yet been conducted on changes in microcirculatory hemodynamics of colorectal adenomas in vivo under endoscopy. The microcirculation of the colorectal adenoma could be observed in vivo by a novel high-resolution magnification endoscopy with blue laser imaging (BLI), thus providing a new insight into the microcirculation of early colon tumors.

AIM

To observe the superficial microcirculation of colorectal adenomas using the novel magnifying colonoscope with BLI and quantitatively analyzed the changes in hemodynamic parameters.

METHODS

From October 2019 to January 2020, 11 patients were screened for colon adenomas with the novel high-resolution magnification endoscope with BLI. Video images were recorded and processed with Adobe Premiere, Adobe Photoshop and Image-pro Plus software. Four microcirculation parameters: Microcirculation vessel density (MVD), mean vessel width (MVW) with width standard deviation (WSD), and blood flow velocity (BFV), were calculated for adenomas and the surrounding normal mucosa.

RESULTS

A total of 16 adenomas were identified. Compared with the normal surrounding mucosa, the superficial vessel density in the adenomas was decreased (MVD: 0.95 ± 0.18 vs 1.17 ± 0.28 μm/μm ², P < 0.05). MVW (5.11 ± 1.19 vs 4.16 ± 0.76 μm, P < 0.05) and WSD (11.94 ± 3.44 vs 9.04 ± 3.74, P < 0.05) were both increased. BFV slowed in the adenomas (709.74 ± 213.28 vs 1256.51 ± 383.31 μm/s, P < 0.05).

CONCLUSION

The novel high-resolution magnification endoscope with BLI can be used for in vivo study of adenoma superficial microcirculation. Superficial vessel density was decreased, more irregular, with slower blood flow.

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Most cited references 22

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Tumor angiogenesis and vascular normalization: alternative therapeutic targets.

Claire Viallard, Bruno Larrivée (2017)

Tumor blood vessels are a key target for cancer therapeutic management. Tumor cells secrete high levels of pro-angiogenic factors which contribute to the creation of an abnormal vascular network characterized by disorganized, immature and permeable blood vessels, resulting in poorly perfused tumors. The hypoxic microenvironment created by impaired tumor perfusion can promote the selection of more invasive and aggressive tumor cells and can also impede the tumor-killing action of immune cells. Furthermore, abnormal tumor perfusion also reduces the diffusion of chemotherapeutic drugs and radiotherapy efficiency. To fight against this defective phenotype, the normalization of the tumor vasculature has emerged as a new therapeutic strategy. Vascular normalization, by restoring proper tumor perfusion and oxygenation, could limit tumor cell invasiveness and improve the effectiveness of anticancer treatments. In this review, we investigate the mechanisms involved in tumor angiogenesis and describe strategies used to achieve vascular normalization.

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Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths.

Ann Zauber, Sidney Winawer, Michael J. O'Brien … (2012)

In the National Polyp Study (NPS), colorectal cancer was prevented by colonoscopic removal of adenomatous polyps. We evaluated the long-term effect of colonoscopic polypectomy in a study on mortality from colorectal cancer. We included in this analysis all patients prospectively referred for initial colonoscopy (between 1980 and 1990) at NPS clinical centers who had polyps (adenomas and nonadenomas). The National Death Index was used to identify deaths and to determine the cause of death; follow-up time was as long as 23 years. Mortality from colorectal cancer among patients with adenomas removed was compared with the expected incidence-based mortality from colorectal cancer in the general population, as estimated from the Surveillance Epidemiology and End Results (SEER) Program, and with the observed mortality from colorectal cancer among patients with nonadenomatous polyps (internal control group). Among 2602 patients who had adenomas removed during participation in the study, after a median of 15.8 years, 1246 patients had died from any cause and 12 had died from colorectal cancer. Given an estimated 25.4 expected deaths from colorectal cancer in the general population, the standardized incidence-based mortality ratio was 0.47 (95% confidence interval [CI], 0.26 to 0.80) with colonoscopic polypectomy, suggesting a 53% reduction in mortality. Mortality from colorectal cancer was similar among patients with adenomas and those with nonadenomatous polyps during the first 10 years after polypectomy (relative risk, 1.2; 95% CI, 0.1 to 10.6). These findings support the hypothesis that colonoscopic removal of adenomatous polyps prevents death from colorectal cancer. (Funded by the National Cancer Institute and others.).

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Long-term colorectal-cancer incidence and mortality after lower endoscopy.

Reiko Nishihara, Kana Wu, Paul Lochhead … (2013)

Colonoscopy and sigmoidoscopy provide protection against colorectal cancer, but the magnitude and duration of protection, particularly against cancer of the proximal colon, remain uncertain. We examined the association of the use of lower endoscopy (updated biennially from 1988 through 2008) with colorectal-cancer incidence (through June 2010) and colorectal-cancer mortality (through June 2012) among participants in the Nurses' Health Study and the Health Professionals Follow-up Study. Among 88,902 participants followed over a period of 22 years, we documented 1815 incident colorectal cancers and 474 deaths from colorectal cancer. With endoscopy as compared with no endoscopy, multivariate hazard ratios for colorectal cancer were 0.57 (95% confidence interval [CI], 0.45 to 0.72) after polypectomy, 0.60 (95% CI, 0.53 to 0.68) after negative sigmoidoscopy, and 0.44 (95% CI, 0.38 to 0.52) after negative colonoscopy. Negative colonoscopy was associated with a reduced incidence of proximal colon cancer (multivariate hazard ratio, 0.73; 95% CI, 0.57 to 0.92). Multivariate hazard ratios for death from colorectal cancer were 0.59 (95% CI, 0.45 to 0.76) after screening sigmoidoscopy and 0.32 (95% CI, 0.24 to 0.45) after screening colonoscopy. Reduced mortality from proximal colon cancer was observed after screening colonoscopy (multivariate hazard ratio, 0.47; 95% CI, 0.29 to 0.76) but not after sigmoidoscopy. As compared with colorectal cancers diagnosed in patients more than 5 years after colonoscopy or without any prior endoscopy, those diagnosed in patients within 5 years after colonoscopy were more likely to be characterized by the CpG island methylator phenotype (CIMP) (multivariate odds ratio, 2.19; 95% CI, 1.14 to 4.21) and microsatellite instability (multivariate odds ratio, 2.10; 95% CI, 1.10 to 4.02). Colonoscopy and sigmoidoscopy were associated with a reduced incidence of cancer of the distal colorectum; colonoscopy was also associated with a modest reduction in the incidence of proximal colon cancer. Screening colonoscopy and sigmoidoscopy were associated with reduced colorectal-cancer mortality; only colonoscopy was associated with reduced mortality from proximal colon cancer. Colorectal cancer diagnosed within 5 years after colonoscopy was more likely than cancer diagnosed after that period or without prior endoscopy to have CIMP and microsatellite instability. (Funded by the National Institutes of Health and others.).

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Author and article information

Contributors

Hai-Bin Dong

Tao Chen

Xiao-Fei Zhang

Yu-Tang Ren

Bo Jiang

Journal

Journal ID (nlm-ta): World J Gastrointest Endosc

Journal ID (publisher-id): WJGE

Title: World Journal of Gastrointestinal Endoscopy

Publisher: Baishideng Publishing Group Inc

ISSN (Electronic): 1948-5190

Publication date (Print): 16 April 2024

Publication date (Electronic): 16 April 2024

Volume: 16

Issue: 4

Pages: 206-213

Affiliations

Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, Beijing 102218, China

Center for Medical Data Science, Beijing Tsinghua Changgung Hospital, Beijing 102218, China

Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, Beijing 102218, China. ryta01044@ 123456btch.edu.cn

Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, Beijing 102218, China

Author notes

Co-first authors: Hai-Bin Dong and Tao Chen.

Co-corresponding authors: Yu-Tang Ren and Bo Jiang.

Author contributions: Zhang XF contributed to statistical analysis of data; Dong HB contributed to drafting of the article; Dong HB and Chen T contributed to analysis and interpretation of the data; Ren YT and Jiang B, as co-corresponding authors, played an important role in the design, progress and summary of the study. Ren YT found that the new endoscope could be used for the study of blood microcirculation, and personally completed all endoscopic operations and designed the analysis indicators. Jiang B introduced new endoscopes, controlled the whole research concept and design, critically revised important contents of the paper, and finally approved the paper.

Corresponding author: Yu-Tang Ren, PhD, Doctor, Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, No. 168 Litang Road, Changping District, Beijing 102218, China. ryta01044@ 123456btch.edu.cn

Article

Other ID: jWJGE.v16.i4.pg206 Publisher-manuscript ID: 91429

DOI: 10.4253/wjge.v16.i4.206

PMC ID: 11045353

SO-VID: c189bc39-fd3c-44f3-a898-c1bf68e9a585

License:

This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

History

Date received : 28 December 2023

Date revision received : 29 January 2024

Date accepted : 18 March 2024

In vivo pilot study into superficial microcirculatory characteristics of colorectal adenomas using novel high-resolution magnifying endoscopy with blue laser imaging

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Abstract

BACKGROUND

AIM

METHODS

RESULTS

CONCLUSION

Related collections

HR-EBSD (High Resolution - Electron Back Scatter Diffraction)

Most cited references 22

Tumor angiogenesis and vascular normalization: alternative therapeutic targets.

Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths.

Long-term colorectal-cancer incidence and mortality after lower endoscopy.

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