Optical markers in duodenal mucosa predict the presence of pancreatic cancer.
OBJECTIVE
Pancreatic cancer remains one of the most deadly cancers and carries a dismal 5-year survival rate of <5%. Therefore, there is urgent need to develop a highly accurate and minimally invasive (e.g., without instrumentation of the pancreatic duct given high rate of complications) method of detection. Our group has developed a collection of novel light-scattering technologies that provide unprecedented quantitative assessment of the nanoscale architecture of the epithelium. We propose a novel approach to predict pancreatic cancer through the assessment of the adjacent periampullary duodenal mucosa without any interrogation of the pancreatic duct or imaging of the pancreas.


METHODS
Endoscopically and histologically normal-appearing periampullary duodenal biopsies obtained from 19 pancreatic cancer patients were compared with those obtained at endoscopy from 32 controls. Biopsies were analyzed using our newly developed optical technologies, four-dimensional elastic light-scattering fingerprinting (4D-ELF) and low-coherence enhanced backscattering (LEBS) spectroscopy.


RESULTS
4D-ELF- and LEBS-derived optical markers from normal-appearing periampullary duodenal mucosa can discriminate between pancreatic cancer patients and normal controls with 95% sensitivity and 91% specificity. Moreover, the diagnostic performance of these optical markers was not compromised by confounding factors such as tumor location and stage.


CONCLUSIONS
Here, we showed, for the first time, that optical analysis of histologically normal duodenal mucosa can predict the presence of pancreatic cancer without direct visualization of the pancreas.
Biomedical Engineering Department, Northwestern University, Illinois, USA.
Yang
Y
Liu
Randall E
RE
Brand
Vladimir
V
Turzhitsky
Young L
YL
Kim
Hemant K
HK
Roy
Nahla
N
Hasabou
Charles
C
Sturgis
Dhiren
D
Shah
Curtis
C
Hall
Vadim
V
Backman
D000368:Aged; D016022:Case-Control Studies; D003952:Diagnostic Imaging / Q000379:methods*; D042241:Early Diagnosis; D004724:Endoscopy; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008027:Light; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D011230:Precancerous Conditions / Q000175:diagnosis* / Q000517:prevention & control; D012542:Scattering, Radiation; D013057:Spectrum Analysis