| dc.description.abstract | Introduction
The incidence of oesophageal adenocarcinoma is increasing. Although improvements have been seen, the overall 5 year survival rate remains poor, at 15.1%. As with other cancers, the survival rate is highest when the disease is confined to the oesophagus.
Barrett’s oesophagus is an acquired condition, characterised by the replacement of the normal distal squamous epithelial lining of the oesophagus with columnar epithelium. Oesophageal adenocarcinoma develops, in most instances, along a pathway of increasing dysplasia in the sections of Barrett’s oesophagus. If dysplasia can be diagnosed accurately, then this would permit treatment prior to the development of adenocarcinoma.
Methods
Samples of Barrett’s oesophagus with varying degrees of dysplasia and adenocarcinoma were measured with Raman point and mapping spectroscopy. Analysis was performed using Matlab®.
Results
Samples of squamous epithelia, Barrett’s oesophagus without dysplasia, with low-grade dysplasia, with high-grade dysplasia and oesophageal adenocarcinoma were measured and analysed. 2078 point spectra measurements and 117 map regions were analysed.
Raman point spectra measurements and Raman mapping differentiated samples without dysplasia from those with dysplasia, and differentiated samples of low-grade dysplasia from those of high-grade dysplasia and adenocarcinoma. The specificity and sensitivity were, however, low.
Conclusion
This research has illustrated the ability of Raman spectroscopy to discern samples of Barrett’s oesophagus with low-grade dysplasia from those with higher grades of dysplasia. This capability could be utilised clinically with in- vivo measurements to identify the areas requiring detailed surveillance and biopsies.
The majority of patients with Barrett’s oesophagus and low-grade dysplasia will never progress to adenocarcinoma. There is currently no means, either via histopathology or via a biomarker, to identify the minority who will develop high- grade dysplasia or adenocarcinoma. Raman spectroscopy may have the ability to do this and I believe this is the path that this technology should pursue. | en_GB |
