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Colon Cancer Screening Technique Shows Continued Promise in New Study
June 10, 2009Recent clinical trials show that a new colon cancer screening technique created by Northwestern University researchers has a high enough sensitivity that it could potentially be as or more successful than a colonoscopy in screening for colon cancer.
The technique uses optical technology, called low-coherence enhanced backscattering (LEBS) spectroscopy, to analyze tissue samples taken from the base of the rectum. Light shines on the tissue, scatters, and some of that light bounces back to sensors in the probe. A computer analyzes the pattern of light scattering, looking for the "fingerprint" of carcinogenesis in the nanoarchitecture of the cells.
Researchers led by Vadim Backman, professor of biomedical engineering at the McCormick School of Engineering and Applied Science, obtained biopsies from patients undergoing colonoscopies and found that LEBS could detect the presence of growths elsewhere in the colon even though it just analyzed tissue from the base of the rectum.
The results were recently published in the journal Cancer Research. Clinical trials have been conducted in collaboration with Hemant Roy, M.D., director of gastroenterology research at NorthShore University HealthSystem.
The study is a step toward clinical application of the technology, since it used tissue samples near the location where doctors may ultimately use a probe to test technology.
"If you have a precancerous lesion in one part of the colon," said Backman, "even tissue that looks normal and is located far from the lesion or polyp will have molecular and other kinds of changes. It's the biological phenomenon called the 'field effect.' No one can detect these changes earlier than we can."
The study examined tissue from 219 patients. Results showed that for advanced polyps, the test had a sensitivity of 100 percent, which means that 100 percent of patients who had polyps were correctly identified as having them.
The larger number of patients in the more recent study allowed researchers to calculate the "area under the receiver operator characteristic" (AUROC), which is an analysis of the accuracy of the test in distinguishing healthy samples from diseased samples. While the sensitivity and specificity of tests may vary based on the threshold set by researchers for diagnosis, the AUROC measures the overall efficacy of the diagnostic technique. The analysis showed an 89.5 percent AUROC for the technique. (Clinically sound tests typically have an AUROC greater than 70 percent.)
The study provides a proof of concept that this sort of analysis could be a minimally intrusive colon cancer screening technique. Further studies with a compatible fiber optic probe are under way for multicenter clinical validation.
The work builds on previous success in using a suite of optical technologies to detect both colon and pancreatic cancer.
Along with Backman and Roy, other authors of the paper are Vladimir Turzhitsky, Young Kim, Michael Goldberg, Patrice Wilson, Jeremy Rogers, Andrew Gomes, Alexey Kromine, Randall Brand, Mohammed Jameel, Andrej Bogovejic and Prabhakar Pradhan.
The research was funded by the National Institutes of Health and the National Science Foundation.
Robert R. McCormick School of Engineering and Applied Science, Northwestern University
The results were recently published in the journal Cancer Research. Clinical trials have been conducted in collaboration with Hemant Roy, M.D., director of gastroenterology research at NorthShore University HealthSystem.
The study is a step toward clinical application of the technology, since it used tissue samples near the location where doctors may ultimately use a probe to test technology.
"If you have a precancerous lesion in one part of the colon," said Backman, "even tissue that looks normal and is located far from the lesion or polyp will have molecular and other kinds of changes. It's the biological phenomenon called the 'field effect.' No one can detect these changes earlier than we can."
The study examined tissue from 219 patients. Results showed that for advanced polyps, the test had a sensitivity of 100 percent, which means that 100 percent of patients who had polyps were correctly identified as having them.
The larger number of patients in the more recent study allowed researchers to calculate the "area under the receiver operator characteristic" (AUROC), which is an analysis of the accuracy of the test in distinguishing healthy samples from diseased samples. While the sensitivity and specificity of tests may vary based on the threshold set by researchers for diagnosis, the AUROC measures the overall efficacy of the diagnostic technique. The analysis showed an 89.5 percent AUROC for the technique. (Clinically sound tests typically have an AUROC greater than 70 percent.)
The study provides a proof of concept that this sort of analysis could be a minimally intrusive colon cancer screening technique. Further studies with a compatible fiber optic probe are under way for multicenter clinical validation.
The work builds on previous success in using a suite of optical technologies to detect both colon and pancreatic cancer.
Along with Backman and Roy, other authors of the paper are Vladimir Turzhitsky, Young Kim, Michael Goldberg, Patrice Wilson, Jeremy Rogers, Andrew Gomes, Alexey Kromine, Randall Brand, Mohammed Jameel, Andrej Bogovejic and Prabhakar Pradhan.
The research was funded by the National Institutes of Health and the National Science Foundation.
Robert R. McCormick School of Engineering and Applied Science, Northwestern University
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Paradoxical protein might prevent cancer
One difficulty with fighting cancer cells is that they are similar in many respects to the body's stem cells. By focusing on the differences, researchers at Karolinska Institutet have found a new way of tackling colon cancer. The study is presented in the prestigious journal Cell.
Coffee break: Compound brewing new research in colon, breast cancer
A compound in coffee has been found to be estrogenic in studies by Texas AgriLife Research scientists.
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Scientists are reporting development of a nano-size capsule that boosts the body's uptake of curcumin, an ingredient in yellow curry now being evaluated in clinical trials for treatment of several diseases.
Colon cancer screening more effective earlier in day, UCLA study finds
The effectiveness of a screening colonoscopy may depend on the time of day it is performed. According to a new UCLA study, early-morning colonoscopies yielded more polyps per patient than later screenings, and fewer polyps were found hour by hour as the day progressed.
Study shows hormone replacement therapy decreases mortality in younger postmenopausal woman
Hormone replacement therapy (HRT) to treat menopausal estrogen deficiency has been in widespread use for over 60 years. Several observational studies over the years showed that HRT use by younger postmenopausal women was associated with a significant reduction in total mortality; available evidence supported the routine use of HRT to increase longevity in postmenopausal women.
Experts issue call to reconsider screening for breast cancer and prostate cancer
Twenty years of screening for breast and prostate cancer - the most diagnosed cancer for women and men - have not brought the anticipated decline in deaths from these diseases, argue experts from the University of California, San Francisco and the University of Texas Health Science Center at San Antonio in an opinion piece published in the "Journal of the American Medical Association."
Metals could forge new cancer drug
Drugs made using unusual metals could form an effective treatment against colon and ovarian cancer, including cancerous cells that have developed immunity to other drugs, according to research at the University of Warwick and the University of Leeds.
New data: Hospital imaging centers poised to pull back, hitting patients hardest in rural areas
Survivors and patients with cancers and heart disease, along with patient advocate organizations and physicians, today urged policymakers to enhance early diagnosis of deadly diseases by preserving access to advanced imaging, such as MRI and CT scans, in final health care reform legislation.
Whole-brain radiotherapy after surgery or radiosurgery not recommended for brain metastases
Whole-brain radiotherapy should not be given routinely to all patients whose cancer has spread to the brain, say researchers who found that using it after surgery or radiosurgery in patients with a limited number of brain metastases and stable cancer in the rest of the body did not extend lives or help patients remain functionally independent for longer.
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