title: Nanocytology of rectal colonocytes to assess risk of colon cancer based on field cancerization.
abstract: Developing a minimally invasive and cost-effective prescreening strategy for colon cancer is critical because of the impossibility of conducting colonoscopy on the entire at-risk population. The concept of field carcinogenesis, in which normal-appearing tissue away from a tumor has molecular and, consequently, nano-architectural abnormalities, offers one attractive approach to identify high-risk patients. In this study, we investigated whether the novel imaging technique partial wave spectroscopic (PWS) microscopy could risk-stratify patients harboring precancerous lesions of the colon, using an optically measured biomarker (L(d)) obtained from microscopically normal but nanoscopically altered cells. Rectal epithelial cells were examined from 146 patients, including 72 control patients, 14 patients with diminutive adenomas, 20 patients with nondiminutive/nonadvanced adenomas, 15 patients with advanced adenomas/high-grade dysplasia, 12 patients with genetic mutation leading to Lynch syndrome, and 13 patients with cancer. We found that the L(d) obtained from rectal colonocytes was well correlated with colon tumorigenicity in our patient cohort and in an independent validation set of 39 additional patients. Therefore, our findings suggest that PWS-measured L(d) is an accurate marker of field carcinogenesis. This approach provides a potential prescreening strategy for risk stratification before colonoscopy.
authors.affiliation: Biomedical Engineering Department, Northwestern University, Evanston, Illinois, USA.
authors.forename: Dhwanil
authors.initials: D
authors.lastname: Damania
authors.forename: Hemant K
authors.initials: HK
authors.lastname: Roy
authors.forename: Hariharan
authors.initials: H
authors.lastname: Subramanian
authors.forename: David S
authors.initials: DS
authors.lastname: Weinberg
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Rex
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Goldberg
authors.forename: Joseph
authors.initials: J
authors.lastname: Muldoon
authors.forename: Lusik
authors.initials: L
authors.lastname: Cherkezyan
authors.forename: Yuanjia
authors.initials: Y
authors.lastname: Zhu
authors.forename: Laura K
authors.initials: LK
authors.lastname: Bianchi
authors.forename: Dhiren
authors.initials: D
authors.lastname: Shah
authors.forename: Prabhakar
authors.initials: P
authors.lastname: Pradhan
authors.forename: Monica
authors.initials: M
authors.lastname: Borkar
authors.forename: Henry
authors.initials: H
authors.lastname: Lynch
authors.forename: Vadim
authors.initials: V
authors.lastname: Backman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003106:Colon / Q000473:pathology*; D003110:Colonic Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008853:Microscopy; D008875:Middle Aged; D049329:Nanostructures; D012007:Rectum / Q000473:pathology*; D012307:Risk Factors; D012737:Sex Factors