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Assessing the additional benefit of an innovative imaging system for colonoscopy

ABSTRACT: Background and study aims A colonoscopy is an important procedure in which a narrow, flexible, telescopic camera is inserted into the back passage to look at the lining of the large bowel. Although it can be an uncomfortable procedure, it is the most effective way to diagnose colorectal cancer (bowel cancer). Although colonoscopies are very effective at finding tumours (neoplasms), it is reported that they do not always spot polyps. A polyp is a very small growth on the inner lining of the colon or rectum. Although most colorectal polyps do not become cancerous, almost all cases of colorectal cancer begin as polyps. It is therefore very important to detect polyps, as their presence increases the risk of colorectal cancer. A possible reason that polyps are sometimes missed in colonoscopies may be because of inadequate equipment. A full spectrum endoscope (FUSE) is a device that has been developed to help lower the miss rate of polyps in routine colonoscopies. The device uses three cameras to give a panoramic view of the colon, allowing for a more complete picture of the colon. The aim of this study is to find out how well this new technology performs in comparison to the standard device used. Who can participate? Adults between 50 and 69 years of age, having their first colonoscopy after testing positively for blood in their stool in a mass screening programme. What does the study involve? Participants are randomly allocated in one of two groups. For participants in the first group, the colonoscopy procedure is completed using a standard forward-viewing colonoscopy. For participants in the second group, the procedure is completed using full spectrum endoscopy (FUSE). After the procedures, the accuracy of the two devices is compared. Participants also are asked to complete a questionnaire after the procedure about their experiences.

DISEASE(S): Colorectal Adenomas,Colorectal Cancer

PROVIDER: 2408141 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Colorectal cancer often arises from adenomatous polyps. Polyps can grow and progress to cancer, but may also remain static in size, regress, or resolve. Prediciting which progress to cancer and which remain benign is difficult. We developed a long-lived murine model of colorectal cancer with tumors that can be followed by colonoscopy. Our aim was to assess whether these tumors have similar growth patterns and histologic fates to human colorectal polyps to identify features to aid in risk stratification of colonic tumors. Long-lived Apcin/+ mice were treated with 4% dextran sodium sulfate to promote colonic tumorigenesis. Tumor growth patterns were characterized by serial colonoscopy, and pathology was determined. Serial biopsies of tumors were obtained for immunohistochemistry and gene expression profiling by microarray analysis with Affymetrix Whole Genome array. Tumors (n=424) grew, remained static, regressed, or resolved over time with different relative frequencies. Newly developed tumors demonstrated dynamic growth patterns with higher rates of growth and resolution, while more established tumors tended to remain static in size. Colonic tumors were hyperplastic lesions (3%), adenomas (73%), intramucosal carcinomas (20%), or adenocarcinomas (3%). Differentially expressed genes between adenomas and intramucosal carcinomas were identified. We did not identify differentially expressed genes between early and late biopsies from the same tumor. This novel murine model of intestinal tumorigenesis develops colonic tumors that can be monitored by serial colonoscopy, mirror growth patterns seen in human colorectal polyps, and progress to colorectal cancer. Further characterization of cellular and molecular features are needed to determine which features can be used to risk-stratify polyps for progress to colorectal cancer and potentially guide prevention strategies. F1 (SWR x C57BL/6) Apcin/+ mice who had been given two treatments of 4% dextran sodium sulfate in drinking water at weaning underwent colonoscopy around 80 days of age. Those with distal colonic tumors amenable to biopsy had two biopsies taken at that time. Tumors were monitored by colonoscopy every 14 days. Every 28 days, two additional biopsies were taken of each tumor. This protocol was repeated until mice were moribund. Six tumors were removed after sacrifice. The earliest and latest biopsies of each tumor were selected for RNA extraction and Affymetrix hybridization.

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Assessing the additional benefit of an innovative imaging system for colonoscopy

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