Abstract
Background and Study AimsPrevious studies have identified that colorectal cancer has different fucosylation levels compared to the normal colon. Ulex europaeus agglutinin-I (UEA-I), which specifically combines with α1-2 fucose glycan, is usually used to detect fucosylation levels. Therefore, we used confocal laser endomicroscopy (CLE) to investigate fluorescently labeled UEA-Fluorescein isothiocyanate (FITC) for detecting colonic cancer.Patients and MethodsWe stained frozen mouse colon tissue sections of normal, adenoma, and adenocarcinoma species with UEA-FITC to detect fucosylation levels in different groups. White light endoscopy and endocytoscopy were first used to detect the lesions. The UEA-FITC was then stained in the mice and human colon tissues in vitro. The CLE was used to detect the UEA-FITC levels of the corresponding lesions, and videos were recorded for quantitation analysis. The diagnostic accuracy of UEA-FITC using CLE was evaluated in terms of sensitivity and specificity.ResultsThe UEA expression level in colorectal cancer was lower than that in normal intestinal epithelium. The fluorescence intensity ratio of UEA-FITC in colorectal cancer was significantly lower than that in normal tissue detected by CLE in both mice and humans. The combination of UEA-FITC and CLE presented a good diagnostic accuracy with a sensitivity of 95.6% and a specificity of 97.7% for detecting colorectal cancer. The positive and negative predictive values were 91.6% and 95.6%, respectively. Overall, 95.6% of the sites were correctly classified by CLE.ConclusionsWe developed a new imaging strategy to improve the diagnostic efficacy of CLE by using UEA-FITC.
Highlights
Combining cancer-specific molecular imaging technologies with optical imaging agents provides a novel technique for cancer detection
The fluorescence intensity ratio of UEA-Fluorescein isothiocyanate (FITC) in colorectal cancer was significantly lower than that in normal tissue detected by confocal laser endomicroscopy (CLE) in both mice and humans
We developed a new imaging strategy to improve the diagnostic efficacy of CLE by using UEA-FITC
Summary
Combining cancer-specific molecular imaging technologies with optical imaging agents provides a novel technique for cancer detection. WLE has several disadvantages: it is insensitive to detecting multifocal and flat tumors, and is insufficient to judge tumor demarcation lines [2]. These disadvantages may affect the detection and complete resection of tumors, which may influence the prognosis of cancer. Cancer-specific molecular imaging agents labeled by fluorescence may augment the distinction between tumors and adjacent normal or benign tissues. Ulex europaeus agglutinin-I (UEA-I), which combines with a1-2 fucose glycan, is usually used to detect fucosylation levels. We used confocal laser endomicroscopy (CLE) to investigate fluorescently labeled UEA-Fluorescein isothiocyanate (FITC) for detecting colonic cancer
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