Fluorescent dye could detect early oesophageal cancer

When sprayed onto the oesophagus the dye attaches to normal, healthy cells but is unable to stick to cancer cells or those in the early stages of turning cancerous. This provides doctors a clear signpost to where the cancer is developing. The research is published in the journal Nature Medicine.

The researchers studied samples of a particular type of oesophageal cancer called adenocarcinoma, the incidence of which is rapidly increasing. It has a detectable pre-cancerous stage called Barrett’s oesophagus which can be easily treated.

The fluorescent dye works by attaching to glycans – molecules on the surface of cells in the oesophagus that are known to change in cancer. When the cells begin to turn cancerous the glycan structures change. Consequently, the dye no longer sticks to the surface of these cells, providing an early indication of where the cancer is developing. At this point the cancer can be treated with radiofrequency ablation – where an electrical current is applied to the affected area to kill the cancer cells.

Lead author of the study Dr Rebecca Fitzgerald, from the MRC Cancer Cell Unit in Cambridge, said:

“Current methods to screen for oesophageal cancer are controversial – it’s costly, uncomfortable and is not completely accurate. Our technique highlights the exact position of a developing oesophageal cancer, and how advanced it is, giving a more accurate picture than current techniques.”

Co-author Professor Kevin Brindle, based at Cancer Research UK’s Cambridge Research Institute, said:

“The benefit of using these markers is that they are specific, relatively cheap and are part of our normal diets so they’re unlikely to cause adverse reactions at the levels that we need to use. We now need to test our technique in patients, but it has great potential to be used with current imaging techniques to help guide treatment for oesophageal cancer.”

Professor Ashok Venkitaraman, director of the MRC Cancer Cell Unit, said:

“One in three of us will contract cancer at some stage in our lives and early detection is key to successful treatment. By understanding the cellular changes that lead to cancer, we can develop new tools such as this that could allow diagnosis at an earlier stage and identification of the patients who are at a higher risk of developing the disease.”

Dr Julie Sharp, senior science information officer at Cancer Research UK, said:

“Oesophageal cancer is one of the most difficult cancers to detect and treat, with only eight per cent of people with the disease surviving at least five years. We urgently need new ways to detect the cancer earlier, and this dye offers a great opportunity to treat the cancer earlier and more successfully, potentially saving many lives a year.”

The researchers used four oesophageal samples to give an insight into how the spray could be used. In two of the samples tested, pre-cancerous areas were not detected using conventional imaging, but the spray clearly highlighted an area that needed treating.

In another patient, their entire oesophagus had been removed because a small pre-cancerous area had been identified. Using current techniques it had been impossible to determine how developed it was, but by using the fluorescent spray, the researchers found the affected area was small enough not to have needed surgery and could have been treated with a less invasive procedure.

Oesophageal cancer is the ninth most common cancer in the UK. Each year around 8,000 people are diagnosed with oesophageal cancer and the incidence of the disease in men has risen by more than 50 per cent in a generation.

Notes to editors

Contact Hannah Isom

Senior press officer, Medical Research Council

T: 0207 395 2345

E: [email protected]

The paper ‘Molecular imaging using fluorescent lectins permits rapid endoscopic identification of dysplasia in Barrett’s esophagus’ by Bird-Lieberman, E.L., et al is published in Nature Medicine.

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