Pilot Study into Superficial Microcirculatory Characteristics of Colorectal Adenomas Using Novel High-resolution Magnifying Endoscopy with Blue Laser Imaging

Overview

Journal World J Gastrointest Endosc

Publisher Baishideng Publishing Group

Date 2024 Apr 29

PMID 38680201

Authors

Hai-Bin Dong

Tao Chen

Xiao-Fei Zhang

Yu-Tang Ren

Bo Jiang

Affiliations

Soon will be listed here.

Abstract

Background: No studies have yet been conducted on changes in microcirculatory hemodynamics of colorectal adenomas under endoscopy. The microcirculation of the colorectal adenoma could be observed 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 1.17 ± 0.28 μm/μm, < 0.05). MVW (5.11 ± 1.19 4.16 ± 0.76 μm, < 0.05) and WSD (11.94 ± 3.44 9.04 ± 3.74, < 0.05) were both increased. BFV slowed in the adenomas (709.74 ± 213.28 1256.51 ± 383.31 μm/s, < 0.05).

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

References

Yoshida N, Hisabe T, Ikematsu H, Ishihara H, Terasawa M, Inaba A . Comparison Between Linked Color Imaging and Blue Laser Imaging for Improving the Visibility of Flat Colorectal Polyps: A Multicenter Pilot Study. Dig Dis Sci. 2019; 65(7):2054-2062. DOI: 10.1007/s10620-019-05930-x. View

Raica M, Cimpean A, Ribatti D . Angiogenesis in pre-malignant conditions. Eur J Cancer. 2009; 45(11):1924-34. DOI: 10.1016/j.ejca.2009.04.007. View

Ang T, Li J, Wong Y, Tan Y, Fock K, Tan M . A prospective randomized study of colonoscopy using blue laser imaging and white light imaging in detection and differentiation of colonic polyps. Endosc Int Open. 2019; 7(10):E1207-E1213. PMC: 6773574. DOI: 10.1055/a-0982-3111. View

Tian Y, Zheng Y, Teng G, Li J, Wang H . Imbalanced mucosal microcirculation in the remission stage of ulcerative colitis using probe-based confocal laser endomicroscopy. BMC Gastroenterol. 2019; 19(1):114. PMC: 6604483. DOI: 10.1186/s12876-019-1037-6. View

De Backer D, Hollenberg S, Boerma C, Goedhart P, Buchele G, Ospina-Tascon G . How to evaluate the microcirculation: report of a round table conference. Crit Care. 2007; 11(5):R101. PMC: 2556744. DOI: 10.1186/cc6118. View

Aihara H, Saito S, Tajiri H . Rationale for and clinical benefits of colonoscopy with narrow band imaging: pathological prediction and colorectal screening. Int J Colorectal Dis. 2012; 28(1):1-7. DOI: 10.1007/s00384-012-1591-7. View

Nishihara R, Wu K, Lochhead P, Morikawa T, Liao X, Qian Z . Long-term colorectal-cancer incidence and mortality after lower endoscopy. N Engl J Med. 2013; 369(12):1095-105. PMC: 3840160. DOI: 10.1056/NEJMoa1301969. View

Sano Y, Tanaka S, Kudo S, Saito S, Matsuda T, Wada Y . Narrow-band imaging (NBI) magnifying endoscopic classification of colorectal tumors proposed by the Japan NBI Expert Team. Dig Endosc. 2016; 28(5):526-33. DOI: 10.1111/den.12644. View

Dos Santos C, Malaman D, Yoshida N, Pereira-Lima J, Onofrio F, Furlan R . Blue laser imaging: a new image-enhanced endoscopy for the diagnosis of colorectal lesions. Eur J Gastroenterol Hepatol. 2018; 30(12):1514-1520. DOI: 10.1097/MEG.0000000000001278. View

10.

Liu H, Wu J, Liu X, Wei N, Liu K, Ma Y . Correlation between microvascular characteristics and the expression of MVD, IGF-1 and STAT3 in the development of colonic polyps carcinogenesis. Exp Ther Med. 2017; 13(1):49-54. PMC: 5245069. DOI: 10.3892/etm.2016.3927. View

11.

Subramaniam S, Hayee B, Aepli P, Schoon E, Stefanovic M, Kandiah K . Optical diagnosis of colorectal polyps with Blue Light Imaging using a new international classification. United European Gastroenterol J. 2019; 7(2):316-325. PMC: 6498803. DOI: 10.1177/2050640618822402. View

12.

Konerding M, Fait E, Gaumann A . 3D microvascular architecture of pre-cancerous lesions and invasive carcinomas of the colon. Br J Cancer. 2001; 84(10):1354-62. PMC: 2363651. DOI: 10.1054/bjoc.2001.1809. View

13.

Viallard C, Larrivee B . Tumor angiogenesis and vascular normalization: alternative therapeutic targets. Angiogenesis. 2017; 20(4):409-426. DOI: 10.1007/s10456-017-9562-9. View

14.

Skinner S, Frydman G, OBrien P . Microvascular structure of benign and malignant tumors of the colon in humans. Dig Dis Sci. 1995; 40(2):373-84. DOI: 10.1007/BF02065424. View

15.

Sakamoto T, Takamaru H, Sekiguchi M, Yamada M, Matsuda T, Saito Y . Reliability of Japan Narrow-Band Imaging Expert Team Classification for the Diagnosis of Colorectal Neoplasms: A Pilot Study. Digestion. 2019; 101(5):638-643. DOI: 10.1159/000501960. View

16.

Staton C, Chetwood A, Cameron I, Cross S, Brown N, Reed M . The angiogenic switch occurs at the adenoma stage of the adenoma carcinoma sequence in colorectal cancer. Gut. 2007; 56(10):1426-32. PMC: 2000239. DOI: 10.1136/gut.2007.125286. View

17.

Yoshida N, Yagi N, Inada Y, Kugai M, Okayama T, Kamada K . Ability of a novel blue laser imaging system for the diagnosis of colorectal polyps. Dig Endosc. 2013; 26(2):250-8. DOI: 10.1111/den.12127. View

18.

Sung J, Lau J, Goh K, Leung W . Increasing incidence of colorectal cancer in Asia: implications for screening. Lancet Oncol. 2005; 6(11):871-6. DOI: 10.1016/S1470-2045(05)70422-8. View

19.

Zauber A, Winawer S, OBrien M, Lansdorp-Vogelaar I, van Ballegooijen M, Hankey B . Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths. N Engl J Med. 2012; 366(8):687-96. PMC: 3322371. DOI: 10.1056/NEJMoa1100370. View

20.

Roy H, Gomes A, Turzhitsky V, Goldberg M, Rogers J, Ruderman S . Spectroscopic microvascular blood detection from the endoscopically normal colonic mucosa: biomarker for neoplasia risk. Gastroenterology. 2008; 135(4):1069-78. PMC: 3405534. DOI: 10.1053/j.gastro.2008.06.046. View