Use of confocal laser endomicroscopy with a fluorescently labeled fatty acid to diagnose colorectal neoplasms
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Feihong Deng1,*, Yuan Fang1,*, Zhiyong Shen2, Wei Gong1, Tao Liu1, Jing Wen1, Wanling Zhang4, Xianjun Zhu2, Hui Zhong1, Tong Wang4, Fachao Zhi1 and Biao Nie3
1Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515 China
2Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, 510515 China
3Department of Gastroenterology, First Affiliated Hospital of Jinan University, Jinan University, Guangzhou, Guangdong Province, 510630 China
4Key Laboratory of Functional Protein Research of Guangdong Higher Education Institutes, Institute of Life and Health Engineering, College of Life Science and Technology, Jinan University, Guangzhou, Guangdong Province, 510632 China
*These authors contributed equally to this work
Biao Nie, email: firstname.lastname@example.org
Keywords: fatty acid metabolism, colorectal neoplasm, confocal laser endomicroscopy, fluorescent agents, de novo FA synthesis
Received: April 19, 2017 Accepted: July 11, 2017 Published: July 24, 2017
Endoscopic treatment for early colorectal cancer closely correlates with patient prognosis. However, endoscopic differentiation between carcinomas and non-neoplastic lesions remains difficult. Here, we topically stained colorectal neoplasms with a fatty acid analogue (BODIPY-FA) and quantified the fluorescent signals using confocal laser endomicroscopy (CLE) and fluorescence microscopy. We also analyzed protein expression in colorectal cancer tissues. We found that expression of fatty acid synthase was elevated, while the expression of fatty acid transporters was reduced in colorectal cancer. In colorectal cancer mouse models and patients, the BODIPY-FA signals were higher in normal epithelia than in carcinomas or colonic intraepithelial neoplasias. BODIPY-FA staining revealed both the arrangement of intestinal glands and the intracellular structures under CLE screening. In a double-blind trial, CLE images stained with BODIPY-FA exhibited greater consistency (κ = 0.68) and overall validity (74.65%) than those stained using intravenous fluorescein sodium (κ = 0.43, 55.88%) when the results were compared with histological diagnoses. These findings suggest that topical use of BODIPY-FA with CLE is a promising imaging approach for early colorectal neoplasm screening.
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