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CASE REPORT
Targeted detection of Barrett’s neoplasia: A case report
Tse-Shao Chang1 ,
Jing Chen2 ,
Richard S. Kwon2 ,
Yang Jiang3 ,
Eric J. Seibel3 ,
D. Kim Turgeon2 ,
Thomas D. Wang1,2,4*
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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
Submitted: 10 November 2023 | Accepted: 22 February 2024 | Published: 3 May 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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 “red flag” to identify the presence of neoplasia. Pathologic tests were conducted on the resected tissues, confirming the presence of stage T1a EAC. The expression EGFR and HER2 was confirmed by immunohistochemistry ex vivo. These findings support integrated imaging as a potential strategy to detect Barrett’s neoplasia.
Keywords
Barrett’s esophagus
High-grade dysplasia
Esophageal adenocarcinoma
Peptide
Heterodimer
Epidermal growth factor receptor
Human epidermal growth factor receptor
Imaging
Funding
This work is supported by the National Institutes of Health (CA163059).
Conflict of interest
Jing Chen and Thomas D. Wang are inventors on patents filed by the University of Michigan on the peptide heterodimer used in the study. Eric J. Seibel is an inventor on patents filed by the University of Washington on the mmSFE. The remaining authors declare that they have no conflicts of interest.
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