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Dynamic contrast-enhanced EUS for quantification of tumor perfusion in colonic cancer: a prospective cohort study - 14/05/18

Doi : 10.1016/j.gie.2018.01.001 
Marie Louise Malmstrøm, MD 1, 2, , Adrian Săftoiu, MD, PhD, MSC, FASGE 3, Lene Buhl Riis, MD, PhD 4, Hazem Hassan, MD 1, Tobias Wirenfeldt Klausen, MSc 5, Mikkel Stræde Rahbek, MSc 6, Ismail Gögenur, MD, DMSc 2 : Prof, Peter Vilmann, MD, DMSc 1 : Prof
1 Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark 
4 Department of Pathology, Herlev Hospital, University of Copenhagen, Herlev, Denmark 
5 Department of Hematology, Herlev Hospital, University of Copenhagen, Herlev, Denmark 
2 Department of Surgery, Zealand University Hospital, University of Copenhagen, Køge, Denmark 
3 University of Medicine and Pharmacy, Research Centre of Gastroenterology and Hepatology, Craiova, Romania 
6 Digital Pathology, Visiopharm, Hørsholm, Denmark 

Reprint requests: Marie L. Malmstrøm, MD, Department of Surgery, Zealand University Hospital, University of Copenhagen, Lykkebækvej 1, 4600 Køge, Denmark.Department of SurgeryZealand University HospitalUniversity of CopenhagenLykkebækvej 14600 KøgeDenmark

Abstract

Background and Aims

Dynamic contrast-enhanced EUS (CE-EUS) for quantification of perfusion in colonic tumors has not previously been reported in the literature. The aim of this study was to investigate correlations between perfusion parameters and vessel density assessed by immunohistochemical staining with antibodies toward CD31 and CD105.

Methods

We conducted a prospective clinical study of 28 patients with left-sided colonic adenocarcinoma who underwent CE-EUS and left-sided hemicolectomy within 2 weeks. CE-EUS recordings were analyzed in 2 regions of interest: the entire tumor and the most enhanced area. Immunohistochemical staining with CD31 and CD105 was performed on tumor tissue sections. The slides were manually scanned for highly vascularized areas, and counting of vessels was performed in hotspots within the tumor and invasive front. New vasculature was assessed by CD105. Associations between CE-EUS and CD31 and CD105 were investigated using Spearman correlation.

Results

We found significant P values for the correlation between CD31 and rise time (rho = .603 [95% confidence interval (95% CI), .238-.816]; P = .001) in tumor tissue and for the correlation between CD31 and rise time (rho = .50 [95% CI, .201-.695]; P = .008) and fall time (rho = .52 [95% CI, .204-.723]; P = .006) corresponding to the invasive front. We found no correlations between perfusion values evaluated by CE-EUS and CD105.

Conclusions

Our results show a significant correlation for vessel density evaluated by CD31 and perfusion parameters evaluated by CE-EUS. This may be the first step toward using real-time CE-EUS for monitoring antiangiogenic therapies in colonic cancer. (Clinical trial registration number: NCT02324023.)

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : AUC, CE-EUS, IHC, ROI, TIC


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 DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. Research support for this study was provided to M.L. Malmstrøm by Agnes and Poul Friis Fund, Astrid Thaysens Legat, Axel Muusfeldts Fund, Dansk Medicinsk Selskab, Krista and Viggo Petersens Fund, Arvid Nilssons Fund, Director Jacob Madsens and wife Olga Madsens Fund, Director Svend Espersens Fund, Lykfeldts Fund, Harboefonden, and the Research Councils of Herlev and Køge Hospitals.
 If you would like to chat with an author of this article, you may contact Dr Malmstrøm at malmstroem@gmail.com.


© 2018  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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