Clinical Trials Logo

Clinical Trial Summary

Acetic acid chromoendoscopy is an established standard technique used to detect dysplasia within the gastrointestinal tract. Acetic acid spray helps to identify neoplasia by highlighting the surface pattern, highlighting the vascular pattern and by a process known as the aceto-whitening reaction, where tissues take acetic acid and turn white for a brief period and then slowly revert back to a normal colour. The neoplastic surface and vascular pattern are all very well described, and have played a big role in the recognition of early cancer. The aceto-whitening reaction is well described but the differential in timing between neoplastic and non-neoplastic areas is not well understood.

The investigators aim to establish the differential in the timing of the disappearance of the aceto-whitening reaction between healthy tissue, dysplastic tissue, intramucosal cancer and invasive cancer after acetic acid dye spray in the oesophagus and colon. By understanding this better, the investigators may be able to predict with greater accuracy whether a highlighted abnormal area is cancer or high grade dysplasia, or whether it is low grade dysplasia or inflammation, which has significant prognostic implications for the patient.

The investigators hypothesize that the differential in the timing of the disappearance of the aceto-whitening reaction between normal and abnormal tissue could help in the detection of gastrointestinal neoplasia.


Clinical Trial Description

This is a prospective pilot study. It is standard practice within our unit to use acetic acid for the detection of neoplasia. No patient would receive any additional intervention that would not normally be performed.

We will record the surface and vascular patterns before and after acetic acid spray. As usual we will then apply acetic acid spray to the Barrett's epithelium and time how long it takes for the aceto whitening to disappear. It is the timing of the disappearance that is the key study intervention. We will biopsy these areas to confirm the diagnosis. Again this is standard practice and no patient will be denied an intervention that is normally performed, and no extra interventions will be performed over and above the standard clinical practice.

We will correlate the histology to the aceto-whitening disappearance time to identify a threshold time which can serve as a cut off between neoplastic and non-neoplastic tissue.

We hypothesise that the aceto-whitening reaction lasts much longer in the normal epithelium of Barrett's oesophagus and colon. This reaction will be much shorter in areas with abnormal pathology like dysplasia or cancer. ;


Study Design

Observational Model: Cohort, Time Perspective: Prospective


Related Conditions & MeSH terms


NCT number NCT01618643
Study type Observational
Source Portsmouth Hospitals NHS Trust
Contact
Status Recruiting
Phase N/A
Start date November 2010
Completion date November 2013

See also
  Status Clinical Trial Phase
Recruiting NCT03554356 - Nitrous Oxide For Endoscopic Ablation of Refractory Barrett's Esophagus (NO FEAR-BE) N/A
Completed NCT03015389 - Wide Area Transepithelial Sample Esophageal Biopsy Combined With Computer Assisted 3-Dimensional Tissue Analysis (WATS3D) For the Detection of High Grade Esophageal Dysplasia and Adenocarcinoma
Completed NCT03434834 - OCT Pilot in Esophagus N/A
Terminated NCT04642690 - Nitrates and IL-8 in Barrett's Esophagus
Completed NCT03468634 - Raman Probe for In-vivo Diagnostics (During Oesophageal) Endoscopy N/A
Recruiting NCT02310230 - An Evaluation of the Utility of the ExSpiron Respiratory Variation Monitor During Upper GI Endoscopy N/A
Completed NCT00217087 - Endoscopic Therapy of Early Cancer in Barretts Esophagus Phase 2
Completed NCT02284802 - Early Detection of Tumors of the Digestive Tract by Confocal Endomicroscopy N/A
Recruiting NCT05530343 - Seattle Biopsy Protocol Versus Wide-Area Transepithelial Sampling in Patients With Barrett's Esophagus Undergoing Surveillance N/A
Active, not recruiting NCT04151524 - Classification of Adenocarcinoma of the Esophagogastric Junction
Completed NCT00955019 - Novel Method of Surveillance in Barrett's Esophagus Phase 2
Terminated NCT00386594 - Pilot Study of Oral 852A for Elimination of High-Grade Dysplasia in Barrett's Esophagus N/A
Completed NCT00576498 - Novel Imaging Techniques in Barrett's Esophagus N/A
Completed NCT02688114 - Healing of the Esophageal Mucosa After RFA of Barrett's Esophagus N/A
Recruiting NCT06071845 - Assessment of a Minimally Invasive Collection Device for Molecular Analysis of Esophageal Samples N/A
Completed NCT02560623 - A Minimally-Invasive Sponge on a String Device for Screening for Barrett's Esophagus N/A
Recruiting NCT05056051 - Wide-Area Transepithelial Sampling in Endoscopic Eradication Therapy for Barrett's Esophagus N/A
Recruiting NCT04001478 - Non-invasive Testing for Early oEesophageal Cancer and Dysplasia
Completed NCT03859557 - The Evaluation of Patients With Esophageal and Foregut Disorders With WATS (Wide Area Transepithelial Sample With 3-Dimensional Computer-Assisted Analysis) vs. 4-Quadrant Forceps Biopsy
Completed NCT04587310 - Does Laparoscopic Sleeve Gastrectomy Lead to Barrett's Esophagus, 5-year Esophagogastroduodenoscopy Findings: A Retrospective Cohort Study