Early Detection of Tumors of the Digestive Tract by Confocal Endomicroscopy

Head and Neck Neoplasms Clinical Trial

Official title:

Early Detection of Tumors of the Digestive Tract by Confocal Endomicroscopy

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02284802
• Other study ID #: NP354/13
• Status: Completed
• Phase: N/A
• Start date: September 10, 2014
• Est. completion date: March 10, 2023

Study information

• Verified date: March 2023
• Source: Instituto do Cancer do Estado de São Paulo
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Confocal endomicroscopy is an emerging technique that allows in vivo imaging of cells and tissue structures of the gastrointestinal mucosa, with a magnification of about 1000 times, guiding optical biopsies in real time. Confocal endomicroscopy represents technique that combines conventional white light image with the confocal microscope probe, thereby allowing examination of the surface epithelium in vivo and histological diagnosis during endoscopy. Among the applications already established for its use, stand out diagnosis of Barrett's esophagus, gastric atrophy and intestinal metaplasia, celiac disease, differentiation of hyperplastic adenomatous polyps of the colon, microscopic colitis and follow-up of patients with inflammatory disease, reducing the need for endoscopic biopsies. The CLE can still detect molecular changes effectively improving the endoscopic diagnosis. This pilot project consists of 07 subprojects which the technology of confocal endomicroscopia will be evaluated and compared with the histological results of biopsy or surgical specimens:

1. confocal endomicroscopy for the diagnosis of high-grade dysplasia and superficial esophageal adenocarcinoma in patients with Barrett's esophagus 2 Diagnosis of superficial esophageal squamous cell carcinoma in patients with head and neck cancer by confocal endomicroscopy 3 Detect the presence of premalignant lesions in the gastric stump in patients with reflux alkaline gastritis after partial gastrectomy 4. detect lesions in the gastric mucosa of patients with familial history of gastric cancer 5 Biliary Strictures: differential diagnosis by confocal endomicroscopia 6 confocal Endomicroscopy of cystic neoplasms of the pancreas 7 Contribution of confocal endomicroscopy for the differential diagnosis of colorectal polyps The project aims to deploy the structure of the Confocal endomicroscopy Endoscopy ICESP, for performing in vivo histological examinations of the digestive tract, biliary tract and pancreas. All research groups involved in the early detection of tumors of the esophagus, stomach, biliary tract, pancreas, colon and rectum may benefit from the implementation of this methodology.

Description:

Confocal Endomicroscopy procedure: eligible patients which consent to participate in the study will be submitted to endoscopic procedures under conscious or deep sedation. The patients will receive an intravenous injection of 2.5-5 mL of 10% sodium fluorescein at the beginning of the endoscopic procedure. The endoscope will target the area of interest and the confocal probe will be passed through the endoscope biopsy channel. The probe will gently and perpendicularly touch the mucosal surface of the area of the interest. The images will be recorded and a presumptive diagnosis will be made. The area of interest will be biopsied and the histology results will be considered the diagnostic gold standard method. We will calculate the diagnostic accuracy of the presumptive diagnosis provided by the confocal endomicroscopy examination.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 87
• Est. completion date: March 10, 2023
• Est. primary completion date: March 10, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Minimum age of 18 years old

• Clinical conditions for the proposed endoscopic procedure

• Sign the informed consent

Exclusion Criteria:

• History of anaphylactic reactions to fluorescein

Related Conditions & MeSH terms

• Barrett Esophagus
• Biliary Duct Stricture
• Colorectal Polyps
• Constriction, Pathologic
• Esophageal Neoplasms
• Gastric Antrectomy Partial
• Head and Neck Neoplasms
• Neoplasms
• Pancreatic Duct Stricture

Intervention

Procedure:
• Confocal endomicroscopy
Confocal endomicroscopy examination during endoscopy

Locations

Country	Name	City	State
Brazil	Instituto do Câncer do Estado de São Paulo - ICESP	São Paulo

Sponsors (1)

Lead Sponsor	Collaborator
Fauze Maluf Filho

Country where clinical trial is conducted

Brazil, 

References & Publications (6)

Baba ER, Safatle-Ribeiro AV, Paduani GF, Giovannini M, Maluf-Filho F. Probe-based confocal laser endomicroscopy for the differential diagnosis of gastric tubular adenoma and intestinal metaplasia in a patient with severe atrophic pangastritis. Gastrointes — View Citation

Bastos VR, Safatle-Ribeiro AV, Baba ER, da Costa Martins B, Maluf-Filho F. The impact of probe-based confocal endomicroscopy on the management of indeterminate bile duct strictures. VideoGIE. 2017 Dec 9;3(1):26-27. doi: 10.1016/j.vgie.2017.10.003. eCollec — View Citation

Safatle-Ribeiro AV, Baba ER, Faraj SF, Rios JT, de Lima MS, Martins BC, Geiger SN, Pennacchi C, Gusman C, Kawaguti FS, Uemura RS, de Melo ES, Ribeiro U Jr, Maluf-Filho F. Diagnostic accuracy of probe-based confocal laser endomicroscopy in Lugol-unstained — View Citation

Safatle-Ribeiro AV, Marques CFS, Pires C, Arraes L, Baba ER, Meirelles L, Kawaguti FS, da Costa Martins B, Lenz LT, de Lima MS, Gusmon-Oliveira CC, Ribeiro U Jr, Maluf-Filho F, Nahas SC. Diagnosis of Clinical Complete Response by Probe-Based Confocal Lase — View Citation

Safatle-Ribeiro AV, Ryoka Baba E, Corsato Scomparin R, Friedrich Faraj S, Simas de Lima M, Lenz L, Costa Martins B, Gusmon C, Shiguehissa Kawaguti F, Pennacchi C, Zilberstein B, Ribeiro U Jr, Maluf-Filho F. Probe-based confocal endomicroscopy is accurate — View Citation

Scomparin RC, Bento LH, Batista CP, Martins BC, Lenz L, Baba ER, Safatle-Ribeiro AV, Maluf-Filho F. Application of confocal endomicroscopy in the diagnostic elucidation of pancreatic cyst. Rev Assoc Med Bras (1992). 2018 Oct;64(10):885-887. doi: 10.1590/1 — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	accuracy of confocal endomicroscopy	Diagnostic accuracy of confocal endomicroscopy for the early detection of tumors of the digestive tract	Less than 7 days