Evidence map›Paper›PMID 27501728›Full record

Observational studySurgical endoscopy2017

A novel methodology for in vivo endoscopic phenotyping of colorectal cancer based on real-time analysis of the mucosal lipidome: a prospective observational study of the iKnife.

James Alexander, Louise Gildea, Julia Balog, Abigail Speller, James McKenzie, Laura Muirhead, Alasdair Scott, Christos Kontovounisios, Shanawaz Rasheed, Julian Teare and 8 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

James AlexanderDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
Louise GildeaDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
Julia BalogWaters Corporation, Wilmslow, UK.
Abigail SpellerDepartment of Histopathology, Imperial College London, London, UK.
James McKenzieDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
Laura MuirheadDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
Alasdair ScottDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
Christos KontovounisiosDepartment of Colorectal Surgery, Royal Marsden Hospital NHS Trust, London, UK.
Shanawaz RasheedDepartment of Colorectal Surgery, Royal Marsden Hospital NHS Trust, London, UK.
Julian TeareDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
Jonathan HoareDepartment of Gastroenterology, Imperial Healthcare NHS Trust, London, UK.
Kirill VeselkovDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
Robert GoldinDepartment of Histopathology, Imperial College London, London, UK.
Paris TekkisDepartment of Colorectal Surgery, Royal Marsden Hospital NHS Trust, London, UK.
Ara DarziDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
Jeremy NicholsonDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.
James KinrossDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK. j.kinross@imperial.ac.uk.
Zoltan TakatsDepartment of Surgery and Cancer, Imperial College London, St. Mary's Hospital, Praed Street, London, NW1 1SQ, UK.

Funding

European Research Council 617896
6 · The paper itself

Abstract

backgroundThis pilot study assessed the diagnostic accuracy of rapid evaporative ionization mass spectrometry (REIMS) in colorectal cancer (CRC) and colonic adenomas.

methodsPatients undergoing elective surgical resection for CRC were recruited at St. Mary's Hospital London and The Royal Marsden Hospital, UK. Ex vivo analysis was performed using a standard electrosurgery handpiece with aspiration of the electrosurgical aerosol to a Xevo G2-S iKnife QTof mass spectrometer (Waters Corporation). Histological examination was performed for validation purposes. Multivariate analysis was performed using principal component analysis and linear discriminant analysis in Matlab 2015a (Mathworks, Natick, MA). A modified REIMS endoscopic snare was developed (Medwork) and used prospectively in five patients to assess its feasibility during hot snare polypectomy.

resultsTwenty-eight patients were recruited (12 males, median age 71, range 35-89). REIMS was able to reliably distinguish between cancer and normal adjacent mucosa (NAM) (AUC 0.96) and between NAM and adenoma (AUC 0.99). It had an overall accuracy of 94.4 % for the detection of cancer versus adenoma and an adenoma sensitivity of 78.6 % and specificity of 97.3 % (AUC 0.99) versus cancer. Long-chain phosphatidylserines (e.g., PS 22:0) and bacterial phosphatidylglycerols were over-expressed on cancer samples, while NAM was defined by raised plasmalogens and triacylglycerols expression and adenomas demonstrated an over-expression of ceramides. REIMS was able to classify samples according to tumor differentiation, tumor budding, lymphovascular invasion, extramural vascular invasion and lymph node micrometastases (AUC's 0.88, 0.87, 0.83, 0.81 and 0.81, respectively). During endoscopic deployment, colonoscopic REIMS was able to detect target lipid species such as ceramides during hot snare polypectomy.

conclusionREIMS demonstrates high diagnostic accuracy for tumor type and for established histological features of poor prognostic outcome in CRC based on a multivariate analysis of the mucosal lipidome. REIMS could augment endoscopic and imaging technologies for precision phenotyping of colorectal cancer.

Indexed as

ColonoscopyAdenomaAdultAgedAged, 80 and overCeramidesColorectal NeoplasmsFemaleHumansIntestinal MucosaIntraoperative CareMaleMass SpectrometryMiddle AgedPhosphatidylglycerolsPhosphatidylserinesCeramidesPhosphatidylglycerolsPhosphatidylserinesPlasmalogensTriglyceridesColorectal cancerMetabolicRapid evaporative ionization mass spectrometry

Identifiers

PMID27501728
PMCPMC5315709

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.