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Confocal Probe-based Endoscopic Imaging, Colorectal Cancer, Gastrointestinal (GI) Pathologies (ASGE-FNDT-1)

21 juin 2012 mis à jour par: Michael Wallace, Mayo Clinic

The Role of Endoscopic Confocal Microscopy in Diagnosing Colorectal Cancer and Other Gastrointestinal Pathologies in Vivo

The recently developed endoscopic Confocal probe microscopy system allows imaging of surface epithelium during ongoing endoscopy (upper and lower) with the potential of immediate diagnosis of various GI pre-malignant and malignant lesions. The purpose of this study is to determine if using this new Confocal probe system can find pre-cancerous abnormalities in the stomach and colon.

Hypothesis: The confocal endomicroscopy images of colorectal lesions during the standard colonoscopies could help the classification in vivo of colorectal neoplastic and non-neoplastic lesions. This could direct further endoscopic interventions such as targeted biopsies of early colorectal cancer lesions and the endoscopic resection of such lesions during screening colonoscopies.

Primary Aim

To determine the key confocal image features of neoplastic and pre-neoplastic colorectal lesions including flat and raised adenomatous polyps, intraepithelial neoplasia and cancer as well as benign lesions such as hyperplastic polyps and normal colonic epithelium and to estimate which morphologic features best distinguish neoplastic and non-neoplastic tissues.
Secondary Aims:
To determine the initial sensitivity and specificity of confocal microendoscopy imaging for classification of adenomatous from hyperplastic polyps of the colon.
In this exploratory phase of the study to develop a library of confocal microendoscopic imaging characteristics of other GI pathologies such as:
1. Barrett's esophagus in comparison to Barrett's esophagus with dysplasia, and normal squamous esophagus.
2. Other encountered inflammatory and neoplastic conditions within the GI tract in which biopsy or removal of tissue would routinely be indicated.

The second phase of the study will focus on establishing the sensitivities, specificities, accuracy of confocal images of colorectal lesions and other GI pathologies as well as inter-observer agreement and learning curve in interpretation of confocal images.

Aperçu de l'étude

Statut

Complété

Les conditions

Description détaillée

Colorectal cancer is the second most common cause of cancer-related death in the U.S. Although removal of pre-malignant polyps has been shown to reduce the risk of colorectal cancer, up to 50% of removed colonic polyps are hyperplastic with no malignant potential. Removal of these benign polyps exposes the patient to polypectomy-related complications and cost without any benefit. Current standard endoscopes with the use of accessory confocal endomicroscopy probe will allow both routine and confocal microscopy imaging. Colonoscopies or upper endoscopies will be performed as routine including conscious sedation. A special fiber through the scope, combined with a small amount of dye called fluorescein given by vein, will be used to obtain microscopic views during the endoscopic procedure. If a colorectal lesion or other GI lesion is found that would normally require biopsy, the site of biopsy will be evaluated by confocal imaging with the Cellvizio-GI Fiberoptic probes prior to biopsy or removal of the suspicious tissue. Following image acquisition, the lesion will be biopsied or removed as per standard clinical care. Standard endoscopic variables for each lesion will be recorded including: name and record number, date, time, an exact time of fluorescein injection and time of image acquisition, lesion location, size, and suspected findings (inflammation, dysplasia, type of polyp) and final histological diagnosis.

Type d'étude

Observationnel

Inscription (Réel)

225

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

États-Unis
- Florida
  - Jacksonville, Florida, États-Unis, 32224
    - Mayo Clinic

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

All patients presenting to Mayo Clinic, Jacksonville, Florida for a screening, surveillance colonoscopy, and/or a diagnostic and surveillance upper endoscopy, will be eligible based on inclusion and exclusion criteria. Eligible patients will be offered entry into the study on the day of the procedure in the hospital GI or Mayo Clinic Jacksonville endoscopy suites.

La description

Inclusion Criteria:

Ages 18 to 100
Any patient undergoing screening and/or surveillance colonoscopy and/or upper endoscopy with possible biopsy or removal of tissue by polypectomy

Exclusion Criteria:

Unwilling to consent
Allergy to fluorescein
Lack of any pathological state that would require biopsy at the time of endoscopy (will be considered "screen failure" since this will not be known until after consent is obtained and sedated endoscopy performed)
Women of child-bearing age who are sexually active and not practicing an acceptable form of contraception

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Modèles d'observation: Cas uniquement
Perspectives temporelles: Transversale

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats	Délai
Endoscopic Confocal microscopy may help distinguish small adenomatous polyps with malignant potential from non-neoplastic (hyperplastic) polyps in real- time enabling immediate diagnosis and removal of only polyps with truly malignant potential. Délai: one year	one year

Mesures de résultats secondaires

Mesure des résultats	Délai
Endoscopic Confocal microscopy has the potential to fundamentally change the way endoscopy and pathology interact by allowing near histological-quality imaging in vivo, without the need, risk, and cost of tissue removal. Délai: one year	one year

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Mayo Clinic

Collaborateurs

American Society for Gastrointestinal Endoscopy

Les enquêteurs

Chercheur principal: Michael B Wallace, M.D., Mayo Clinic

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Publications générales

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 mars 2008

Achèvement primaire (Réel)

1 décembre 2010

Achèvement de l'étude (Réel)

1 juin 2012

Dates d'inscription aux études

Première soumission

31 mars 2009

Première soumission répondant aux critères de contrôle qualité

1 avril 2009

Première publication (Estimation)

2 avril 2009

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Estimation)

22 juin 2012

Dernière mise à jour soumise répondant aux critères de contrôle qualité

21 juin 2012

Dernière vérification