Page 96 - GTM-3-2

Global Translational Medicine

CASE REPORT
Targeted detection of Barrett’s neoplasia: A case

report

Tse-Shao Chang 1 , Jing Chen , Richard S. Kwon , Yang Jiang , Eric J. Seibel ,
2
3
3
2
2
D. Kim Turgeon , and Thomas D. Wang 1,2,4 *
1 Department of Mechanical Engineering, College of Engineering, University of Michigan, Ann Arbor,
Michigan, United States of America
2 Department of Internal Medicine, Division of Gastroenterology, Michigan Medicine, University of
Michigan, Ann Arbor, Michigan, United States of America
3 Department of Mechanical Engineering, Human Photonics Laboratory, College of Engineering,
University of Washington, Seattle, Washington, United States of America
4 Department of Biomedical Engineering, College of Engineering, University of Michigan, Ann Arbor,
Michigan, United States of America

Abstract

Barrett’s esophagus (BE) is a precursor condition for esophageal adenocarcinoma
(EAC). This case report describes the in vivo use of a fluorescently-labeled peptide
heterodimer specific for epidermal growth factor receptor (EGFR) and human
epidermal growth factor receptor (HER2) to identify residual neoplasia in a 52-year-
old female patient with BE. This targeted contrast agent was topically administered
after an incomplete endoscopic mucosal resection of high-grade dysplasia with
carcinoma in situ. A flexible fiber-coupled multi-modal scanning fiber endoscope
was used to capture near-infrared fluorescence images. This instrument was passed
through the working channel of a standard upper endoscope for use as an accessory.
Increased fluorescence intensity was observed from nodular mucosa as a real-time
*Corresponding author: “red flag” to identify the presence of neoplasia. Pathologic tests were conducted on
Thomas D. Wang
(thomaswa@umich.edu) the resected tissues, confirming the presence of stage T1a EAC. The expression EGFR
and HER2 was confirmed by immunohistochemistry ex vivo. These findings support
Citation: Chang T, Chen J,
Kwon RS, et al. Targeted detection integrated imaging as a potential strategy to detect Barrett’s neoplasia.
of Barrett’s neoplasia: A case report.
Global Transl Med. 2024;3(2):2223.
doi: 10.36922/gtm.2223 Keywords: Barrett’s esophagus; High-grade dysplasia; Esophageal adenocarcinoma;
Received: November 10, 2023 Peptide; Heterodimer; Epidermal growth factor receptor; Human epidermal growth
Accepted: February 22, 2024 factor receptor; Imaging
Published Online: May 3, 2024
Copyright: © 2024 Author(s).
This is an Open Access article
distributed under the terms of the 1. Background
Creative Commons Attribution
License, permitting distribution, Barrett’s esophagus (BE), which is a precursor condition for esophageal adenocarcinoma
and reproduction in any medium, (EAC), is commonly found in patients suffering from chronic acid reflux. This metaplastic
provided the original work is
properly cited. mucosa presents an increased risk of transforming into low-grade dysplasia (LGD), high-
grade dysplasia (HGD), and EAC. In the Western countries, EAC has been increasing rapidly
1
Publisher’s Note: AccScience
2
Publishing remains neutral with in incidence and is associated with a poor 5-year survival rate of approximately 20%. 3,4
regard to jurisdictional claims in
published maps and institutional White light endoscopy (WLE) with random biopsies has been recommended by major
5
affiliations. medical societies for cancer surveillance in patients with BE. However, this procedure
Volume 3 Issue 2 (2024) 1 doi: 10.36922/gtm.2223