Details

Details

Digestive pathology and especially digestive cancers are a major health problem in the world, being on the 1st place in the tumor pathology, with more than 3 million new found cancers annually and more than 2.2 million deaths annually. The persistent localizations in order of their incidence in Romania are represented by colorectal, gastric, esophageal, hepatic and pancreatic cancers, most of them being curable in an early stage. The use of modern imaging devices in the digestive endoscopy field has revolutionized the management of the patients that have digestive disorders, as well as the early detection of digestive cancers through screening programs for the risk patients groups. Therefore, digestive endoscopy has benefited from the introduction of new image processing methods, with the increase of the diagnostic accuracy for the last 2 years (endoscopic autofluorescence, optical coherence tomography, respectively laser confocal endo-microscopy

 

Currently, digestive cancers are defined by identifying the morphologic characteristics detected through endoscopy or microscopy. Although the accuracy and precision of the diagnosis may be increased through a better practice in recognizing the lesions pattern, the target will be the development of some „optical biopsies”, meaning some recognizing systems that can detect cancers in real time. The endoscopic methods of high performance mentioned above determine the improvement of the images, and the progressive „computerization” of the endoscopy will definetely increase the physicians’ diagnosis abilities. The computerized simulation will become an essential study element and abilities assessment. The integration of the research efforts through the patterns of this project will allow the accomplishment of „intelligent endoscopic systems” with high dimensioned database memory that will automatize many of the aspects of the endoscopic diagnosis. Moreover, the accomplishment of the early diagnosis through complex genomic and proteomic techniques that allow the detection of molecular modifications (for example the level of the DNA mutations and genetic expressions, respectively the coded proteins expression), will allow the change of health politics and the management of the digestive cancers patients.

 

The general objective of the PYRAMID project proposes the creation of the infrastructure necessary for the development of the researches in the early diagnosis within the digestive malignant pathology. The project proposes to use last generation imaging devices (endoscopic autoflourescence, optical coherence tomography, respectively laser confocal endo-microscopy) by generating the creation of a unifying movement by involving the young researchers into the objective and research area FP7. The bioptic fragments drawn during these complex imaging explorations will be further assessed through molecular pathological complex techniques, including in situ hybridization, computerized analysis of microscopic images, laser microdissection, virtual microscopy and monolayer liquid cytology. The molecular biology techniques used will include macro- / microarray systems, double by real-time PCR and DNA sequencing .

The project is based on the accomplishment of the following specific objectives:
 
A. Reaching an early diagnosis in real time by using laser confocal endo-microscopy together with morpho-pathology standard techniques. The introduction of this technique will develop multiple research themes that refer to reaching the pathology diagnosis in real time and characterizing the anomalies of the digestive tube mucous membrane, for the infections diagnosis, early cancers, dysplasia, metaplasya and other premalignant lesions. The studies will be made in comparison with other recent imaging techniques (endoscopic autofluorescence, optical coherence tomography, etc). By introducing this system the way to the molecular imaging explorations is opened allowing the way to new gastrointestinal indications (for example in vivo analysis of the receptors implied in the oncogenetics processes).
 
B. Reaching the pathology diagnosis through conventional and modern methods.The conventional investigation methods (usual and special colorations) allow the primary identification of the preneoplasic and malignant neoplasic processes. The immuno-histochemical technique allows, within a second stage of the investigation, to correctly establish the neoplasic processes, to identify possible prognostic factors and, finally some possible therapeutic targets. The in situ hybridization technique (ISH) is a first step towards the elucidation of the carcinogenesis mechanisms at molecular level. The laser microdissection method is animportant connection pivot between the pathology investigation and the molecular investigation, by identifying the interest lesion areas on pathology smears, the individual cells on cytological preparations or some cellular types from cells cultures and then drawing cellular groups or individual cells that will be transferred for a molecular study.
 
C. The use of molecular and cellular biology techniques in order to standardize the gene profiles in the digestive pathology. The development and evolution of a malignant tumor process are accompanied by complex modifications within the gene expression mode. The micro­array technique represents an efficient and feasible technique in obtaining and comparing the profiles of the gene expression at healthy individuals with premalignant lesions, as well as at those diagnosed with digestive malignant pathology.  The validation of the data obtained through this technique will be made by individually assessing the genes with modified activity through the Real-Time PCR technique (qPCR). Some patterns of the gene expression may transform into early diagnosis criteria useful in the digestive cancers management.
 
Updated on 9/8/21, 6:34 PM