High Resolution Infrared Spectroscopic Analysis Of Human Colorectal Pathology
Griggs, Rebecca Katie Louise
Thesis or dissertation
University of Exeter
Epithelial misplacement is a benign pathology of the intestines that mimics invasive carcinoma and leads to a high degree of diagnostic difficulty in the discrimination between the two by pathologists. Particular difficulties are associated with the diagnosis between the two, and currently a National Expert Board of specialist pathologists delivers a second opinion for equivocal cases referred from local Hospitals. Novel analysis techniques to assist the diagnosis of epithelial misplacement vs. Cancer would not only aid the Board in the diagnosis, but speed up time taken to diagnosis for future patient management, and therefore increase overall patient satisfaction. This research aims to define the use of high resolution spectroscopy in the colon and assess its use in analysis of formalin-fixed paraffin-embedded tissue that has been routinely processed by the pathology laboratory. It is predicted that it will be an accurate, rapid and non-destructive novel diagnostic technique, and particularly useful in difficult cases such as in the discrimination of epithelial misplacement from cancer, making it a useful addition to the diagnostic process to improve efficiency of the patient diagnostic and treatment pathway. 65 colonic samples were analysed from a total of 58 patients diagnosed with various colonic pathologies and spectra measured in high resolution using the Agilent® 620 FTIR microscope coupled to a 670 Agilent spectrometer in transmission mode. Spectra were then fed into a specialist computer software programme, analysed using principal component-fed linear discriminant analysis model and tested with a leave one sample out cross validation method. The ‘Two Group’ Model defined the ability of the high resolution spectral analysis to discriminate between epithelial misplacement and cancer with a sensitivity of 74.6% and specificity of 82.3%. These results are excellent and have never been recorded previously in the literature. However, further research is required to assess its role in the discrimination of various other colonic pathologies, and the model needs independent testing with new cases of both epithelial misplacement and cancer to continue the assessment of the novel high resolution technique.
MbyRes in Physics