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Differential diagnosis of colorectal neoplastic and non-neoplastic lesions with real-time numerical color analysis using autofluorescence endoscopy

ABSTRACT: Interventions: From November 2010 to August 2012 Following the detection of colorectal lesions in WL observation, the lesions were diagnosed for neoplastic or non-neoplastic. In autofluorescence mode, color-tone sampling is performed on the area that had no halation or no bleeding points which might hamper analysis by the other endoscopist who did not know details of the lesion. Surrounding normal colonic mucosa was also analyzed for its color-tone in order to compare both G/R ratios. Lesions with G/R of < 1.01 are judged to be neoplastic and that with G/R of > 1.01 are considered to be non-neoplastic. Consecutively, all lesions analyzed in the present study are endoscopically removed or biopsied and the specimens are submitted to pathologic evaluation. Finally, pre-removal diagnoses and final pathological diagnoses are compared to each other in order to calculate the diagnostic yield of G/R ratio in the differential diagnosis of colorectal neoplastic lesions from non-neoplastic lesions. Pathologic diagnosis Histopathologic examination of the endoscopically or surgically resected specimen was performed on hematoxylin and eosin-stained sections, with reference to Japanese classification of colorectal carcinoma4. Lesions were classified into 2 categories based on the final pathological diagnoses, neoplastic lesions and non-neoplastic lesions. Neoplastic lesions included 5 pathological types, submucosal invasive cancer, intramucosal cancer, tubular or villous adenoma, traditional serrated adenoma (TSA) and sessile serrated adenoma (SSA). Non-neoplastic lesion included only hyperplastic lesion. Primary outcome(s): Diagnostic yields of the cut-off value for AF index in the differential diagnosis between colorectal neoplastic and non-neoplastic lesions Study Design: Parallel Non-randomized

DISEASE(S): Colorectal Tumor

PROVIDER: 2622947 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:The identification of genomic alterations occurring in neoplastic lesions provides insight into both lesion occurrence and disease progression. In this study we used microarray comparative genomic hybridization (CGH) to investigate genetic changes in atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS), as the presence of these lobular neoplastic lesions is an indicator of risk in the development of invasive breast cancer. DNA was extracted from microdissected archival breast tissue containing ALH or LCIS, lacking adjacent invasive carcinoma, and subjected to whole-genome tiling path microarray-CGH using the submegabase resolution tiling set (SMRTr)-array platform. Twelve ALH and 13 LCIS lesions were examined. Copy number alterations were identified using statistical criteria and validated with Real-Time PCR and fluorescence in situ hybridization. From statistical analysis, a greater number of alterations were observed in ALH compared to LCIS. Alterations common to ALH include gain at 2p11.2 and loss at 7p11.2-p11.1 and 22q11.1. Alterations common to LCIS include gain at 20q13.13 and loss at 19q13.2-q13.31. In both ALH and LCIS, we observed loss of 16q21-q23.1, an altered region previously identified in lobular neoplasia and invasive carcinoma. The validation of select alterations reinforces the genomic signature. This study represents the first whole-genome investigation of lobular neoplastic breast lesions using clinical archival specimens. The identified genomic signature includes copy number alterations not previously identified for lobular neoplasia. This genomic signature, common to ALH and LCIS, suggests a role for the acquisition of novel genomic alterations in the aberrant cellular proliferation that defines lobular neoplasia. Keywords: comparative genomic hybridization, high resolution analysis of atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS) human archival breast lesions by whole genome tiling path array CGH

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Differential diagnosis of colorectal neoplastic and non-neoplastic lesions with real-time numerical color analysis using autofluorescence endoscopy

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