Vibrational Spectroscopy for Endometrial Cancer Diagnosis

NCT ID: NCT05026073

Last Updated: 2021-08-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-01-19

Study Completion Date

2024-11-30

Brief Summary

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The purpose of this study is to investigate the ability of vibrational spectroscopic techniques, Raman spectroscopy and Attenuated Total Reflection - Fourier Transform Infrared spectroscopy (ATR-FTIR), to accurately differentiate endometrial tissue, lymph nodes and blood samples with womb cancer or endometrial hyperplasia from healthy controls.

Detailed Description

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Womb cancer is the sixth most common cancer in women, with rising incidence worldwide. Current diagnostic strategies are time consuming, invasive and have limited accuracy, furthermore there is no population-wide screening. Treatment depends on patients' health, type of disease and spread at the time of diagnosis. Most women will be offered surgery, however the role of lymph node dissection in early stage disease remains controversial.

There is therefore a need for an objective, accurate test, able to detect pre-cancer and cancer early and able to identify metastatic node involvement, so that lymph node excision is performed only when necessary.

Attenuated Total Reflection - Fourier Transform Infrared (ATR-FTIR) spectroscopy and Raman spectroscopy are non-invasive, objective techniques that use the interaction of light within tissues to gain detailed information about the chemical composition of biological samples. These methods have shown tremendous potential for improving diagnosis and treatment of cancer.

This study aims to use Vibrational Spectroscopy to examine blood plasma and serum, endometrial biopsies via Pipelle device and pelvic/para-aortic lymph nodes for the presence of endometrial pre-cancer and cancer changes. The analyses will be performed on fresh (wet) as well as dried samples.

The ultimate goal is to develop a point-of-care test and an intra-operative tool for endometrial cancer screening and diagnosis. Such a test could speed up endometrial cancer diagnosis, reduce treatment delays and individualise patients care.

Conditions

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Endometrial Cancer Endometrial Hyperplasia

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Group 1 Endometrial Cancer:

Women with histological diagnosis of cancer of the endometrium (any type) undergoing hysterectomy

Information about clinical risk factors for endometrial cancer and endometrial hyperplasia

Intervention Type BEHAVIORAL

age, race, parity, body mass index, last menstrual period, menstrual cycle type, hypertension, type II diabetes, anovulation, polycystic ovary syndrome, indication for hysterectomy and smoking history. Other epidemiologic risk factors including tamoxifen exposure, history of breast cancer, current hormone therapy use, anticoagulant use, oral contraception use, family history of endometrial, breast or colon cancer.

Blood and endometrial tissue sampling

Intervention Type PROCEDURE

* All women will undergo planned hysterectomy.
* Venous blood sample will be collected prior to surgery.
* Endometrial sampling via Pipelle device will be performed immediately prior to hysterectomy
* Endometrial biopsy from the hysterectomy specimen will be obtained under direct vision

The plasma and serum obtained from the blood samples will be analysed with ATR-FTIR and Raman spectroscopes. Spectra from both wet and dry specimens will be recorded.

All tissue samples retrieved will be placed in Phosphate Buffered Solution for transfer to the histopathology laboratory. Spectra will be collected from the fresh samples with ATR-FTIR and Raman spectroscopes. Spectral analyses will subsequently be repeated on dry samples post fixation and processing.

All tissue samples will undergo haematoxylin and eosin staining after spectral analysis for standard histopathological confirmation.

Lymph node sampling

Intervention Type PROCEDURE

Lymph nodes will be excised if recommended as part of the standard treatment for endometrial cancer.

Each node will be cut in half or in quarters, depending on size, to expose the core. Wet and dry spectral analysis will be performed, followed by staining for histopathological confirmation.

Group 2 Endometrial Hyperplasia:

Women with histological diagnosis of endometrial hyperplasia (with or without atypia) undergoing hysterectomy

Information about clinical risk factors for endometrial cancer and endometrial hyperplasia

Intervention Type BEHAVIORAL

age, race, parity, body mass index, last menstrual period, menstrual cycle type, hypertension, type II diabetes, anovulation, polycystic ovary syndrome, indication for hysterectomy and smoking history. Other epidemiologic risk factors including tamoxifen exposure, history of breast cancer, current hormone therapy use, anticoagulant use, oral contraception use, family history of endometrial, breast or colon cancer.

Blood and endometrial tissue sampling

Intervention Type PROCEDURE

* All women will undergo planned hysterectomy.
* Venous blood sample will be collected prior to surgery.
* Endometrial sampling via Pipelle device will be performed immediately prior to hysterectomy
* Endometrial biopsy from the hysterectomy specimen will be obtained under direct vision

The plasma and serum obtained from the blood samples will be analysed with ATR-FTIR and Raman spectroscopes. Spectra from both wet and dry specimens will be recorded.

All tissue samples retrieved will be placed in Phosphate Buffered Solution for transfer to the histopathology laboratory. Spectra will be collected from the fresh samples with ATR-FTIR and Raman spectroscopes. Spectral analyses will subsequently be repeated on dry samples post fixation and processing.

All tissue samples will undergo haematoxylin and eosin staining after spectral analysis for standard histopathological confirmation.

Group 3 Controls:

Healthy women undergoing hysterectomy for a benign reason

Information about clinical risk factors for endometrial cancer and endometrial hyperplasia

Intervention Type BEHAVIORAL

age, race, parity, body mass index, last menstrual period, menstrual cycle type, hypertension, type II diabetes, anovulation, polycystic ovary syndrome, indication for hysterectomy and smoking history. Other epidemiologic risk factors including tamoxifen exposure, history of breast cancer, current hormone therapy use, anticoagulant use, oral contraception use, family history of endometrial, breast or colon cancer.

Blood and endometrial tissue sampling

Intervention Type PROCEDURE

* All women will undergo planned hysterectomy.
* Venous blood sample will be collected prior to surgery.
* Endometrial sampling via Pipelle device will be performed immediately prior to hysterectomy
* Endometrial biopsy from the hysterectomy specimen will be obtained under direct vision

The plasma and serum obtained from the blood samples will be analysed with ATR-FTIR and Raman spectroscopes. Spectra from both wet and dry specimens will be recorded.

All tissue samples retrieved will be placed in Phosphate Buffered Solution for transfer to the histopathology laboratory. Spectra will be collected from the fresh samples with ATR-FTIR and Raman spectroscopes. Spectral analyses will subsequently be repeated on dry samples post fixation and processing.

All tissue samples will undergo haematoxylin and eosin staining after spectral analysis for standard histopathological confirmation.

Interventions

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Information about clinical risk factors for endometrial cancer and endometrial hyperplasia

age, race, parity, body mass index, last menstrual period, menstrual cycle type, hypertension, type II diabetes, anovulation, polycystic ovary syndrome, indication for hysterectomy and smoking history. Other epidemiologic risk factors including tamoxifen exposure, history of breast cancer, current hormone therapy use, anticoagulant use, oral contraception use, family history of endometrial, breast or colon cancer.

Intervention Type BEHAVIORAL

Blood and endometrial tissue sampling

* All women will undergo planned hysterectomy.
* Venous blood sample will be collected prior to surgery.
* Endometrial sampling via Pipelle device will be performed immediately prior to hysterectomy
* Endometrial biopsy from the hysterectomy specimen will be obtained under direct vision

The plasma and serum obtained from the blood samples will be analysed with ATR-FTIR and Raman spectroscopes. Spectra from both wet and dry specimens will be recorded.

All tissue samples retrieved will be placed in Phosphate Buffered Solution for transfer to the histopathology laboratory. Spectra will be collected from the fresh samples with ATR-FTIR and Raman spectroscopes. Spectral analyses will subsequently be repeated on dry samples post fixation and processing.

All tissue samples will undergo haematoxylin and eosin staining after spectral analysis for standard histopathological confirmation.

Intervention Type PROCEDURE

Lymph node sampling

Lymph nodes will be excised if recommended as part of the standard treatment for endometrial cancer.

Each node will be cut in half or in quarters, depending on size, to expose the core. Wet and dry spectral analysis will be performed, followed by staining for histopathological confirmation.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Endometrial cancer group:

* Established histopathological diagnosis of cancer of the endometrium (any stage and subtype)
* Patients must be eligible for primary staging surgery (any route, e.g. laparoscopy and laparotomy)
2. Endometrial hyperplasia group:

* Established histopathological diagnosis of endometrial hyperplasia (with or without atypia)
* Treatment with hysterectomy deemed necessary
3. Control group

* Healthy with benign disease, non-malignancy
* Undergoing hysterectomy (any route, e.g. laparoscopy and laparotomy)

Exclusion Criteria

* Patient's refusal / inability to consent
* Synchronous gynaecological cancer (ovary, cervix, fallopian tubes)
* Previous pelvic radiotherapy
* Previous hysterectomy
* Undiagnosed vaginal bleeding
* Previous endometrial ablation
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Nottingham University Hospitals NHS Trust

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ketankumar Gajjar, MD

Role: PRINCIPAL_INVESTIGATOR

Nottingham University Hospitals NHS Trust

Locations

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Nottingham University Hospitals NHS Trust

Nottingham, England, United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Roberta Schiemer, MBBS

Role: CONTACT

0115 969 1169

Ketankumar Gajjar, MD

Role: CONTACT

0115 969 1169

Facility Contacts

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Roberta Schiemer, MBBS

Role: primary

Other Identifiers

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19ON033

Identifier Type: -

Identifier Source: org_study_id

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