Quantitative fluorescence endoscopy (QFE) is a new technique that can visualise and quantify fluorescently tagged tumour tissue. In 25 patients with locally advanced rectal cancer (LARC), we evaluated QFE targeting vascular endothelial growth factor A (VEGFA) to detect residual tumour after neoadjuvant chemoradiotherapy (nCRT). QFE detected significantly higher fluorescence in tumour compared with normal rectal tissue and fibrosis, and improved prediction of final pathology results in 16% of patients compared with standard MRI and white-light endoscopy. QFE is a promising technique to aid clinical response assessment in patients with LARC and warrants further validation in larger clinical trials. ClinicalTrials.gov (NCT01972373). Patients with LARC receive nCRT followed by surgery to achieve local disease control. Interestingly, 15%–27% of patients have a pathological complete response, that is, no residual cancer cells are found in the surgical specimen.1–3 There is an increasing interest in identifying patients with a clinical complete response before surgery, as non-operative management for these patients is associated with high survival rates, reduced morbidity and improved functional outcomes.4–8 However, assessing tumour response after nCRT is challenging. White-light endoscopy provides only morphological information, while MRI cannot always distinguish viable tumour from fibrosis.9–11 QFE is a novel endoscopy technique that visualises and quantitatively measures the presence of targeted fluorescence tracers in tissue. We hypothesised that VEGFA-targeted QFE can be of additional value in restaging patients with LARC. In untreated patients, QFE showed clearly enhanced fluorescence in all rectal tumours compared with normal rectal tissue (figure 1A). The tumour-to-normal ratio of 3.1 (figure 1B) signifies QFE can be used to localise rectal cancer. Figure 1 (A) Representative fluorescence images of the quantitative fluorescence endoscopy (QFE) procedure in untreated rectal cancer. From left to right: a high-definition white-light video endoscope image; a white-light image from the QFE fibreoptic, followed by the corresponding near-infrared …

中文翻译：

---

定量荧光内窥镜：一种评估局部晚期直肠癌新辅助治疗反应的创新内窥镜方法


定量荧光内窥镜（QFE）是一种新技术，可以可视化和量化荧光标记的肿瘤组织。在 25 名局部晚期直肠癌 (LARC) 患者中，我们评估了靶向血管内皮生长因子 A (VEGFA) 的 QFE，以检测新辅助放化疗 (nCRT) 后残留的肿瘤。与标准 MRI 和白光内窥镜检查相比，QFE 检测到肿瘤中的荧光明显高于正常直肠组织和纤维化，并改善了 16% 患者最终病理结果的预测。 QFE 是一种很有前途的技术，可以帮助评估 LARC 患者的临床反应，并值得在更大规模的临床试验中进一步验证。 ClinicalTrials.gov (NCT01972373)。 LARC 患者接受 nCRT，然后进行手术以实现局部疾病控制。有趣的是，15%–27% 的患者具有病理学完全缓解，即手术标本中未发现残留癌细胞。1–3 人们越来越关注在手术前识别临床完全缓解的患者，因为非- 这些患者的手术治疗与高生存率、降低发病率和改善功能结果相关。4-8 然而，评估 nCRT 后的肿瘤反应具有挑战性。白光内窥镜仅提供形态学信息，而 MRI 不能总能区分活肿瘤和纤维化。9–11 QFE 是一种新型内窥镜技术，可可视化并定量测量组织中目标荧光示踪剂的存在。我们假设 VEGFA 靶向 QFE 对 LARC 患者的重新分期具有附加价值。在未经治疗的患者中，与正常直肠组织相比，QFE 在所有直肠肿瘤中显示出明显增强的荧光（图 1A）。 肿瘤与正常细胞的比率为 3.1（图 1B），表明 QFE 可用于定位直肠癌。图 1 (A) 未经治疗的直肠癌定量荧光内窥镜 (QFE) 程序的代表性荧光图像。从左到右：高清白光视频内窥镜图像；来自 QFE 光纤的白光图像，随后是相应的近红外……