The work was supported by the National Cancer Institute and the National Science Foundation.
"Our initial study is very promising," Wax said of the findings. "We looked at tissue removed from just a handful of patients and were able to get 100 percent sensitivity. We could detect pre-cancer in the esophagus and distinguish it from normal tissue like you would find in the stomach."
The fa/LCI device detects irregularities in the nucleus, or central component, of cells, through changes in the way laser light scatters. "The size and shape of cell nuclei are powerful indicators of this precancerous condition called dysplasia, which literally means 'bad growth'," Wax said. "Typically, nuclei are a fairly consistent size. However, when you go down the road toward cancer, you get irregular and enlarged cell nuclei.
"Our device lets us measure those changes with much better accuracy than any imaging technique," Wax said.
His team plans to begin a small clinical trial of the advanced endoscope in collaboration with researchers at Duke University Medical Center. The team also is conducting animal studies to test the feasibility of incorporating fa/LCI into instruments for examining the colon, lung and other organs. Based on a study in hamsters, Wax and Duke postdoctoral researcher Kevin Chalut reported in the February 2007 issue of Cancer Epidemiology Biomarkers & Prevention that the technique might also be used in the identification of early lung cancer.
Wax said he and his colleagues have launched a company, called Oncoscope, to pursue the commercial development of fa/LCI devices. If all goes well, a new and improved endoscope might be ready for the clinic in three to five years, he said.