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Early Diagnosis of Upper Aerodigestive Tract Cancer by Autofluorescence

Early Diagnosis of Upper Aerodigestive Tract Cancer by Autofluorescence Abstract Objective: To explore the potential of autofluorescence spectroscopy as a tool for early detection of upper aerodigestive tract cancer. Design: Autofluorescence spectral characteristics of 19 untreated oral and oropharyngeal lesions in 13 patients were studied with excitation wavelengths of 370 and 410 nm generated by a nitrogen pumped dye laser. Ten healthy volunteers were recruited to characterize the fluorescence spectra of normal mucosa at different oral sites and to study individual variations. Fluorescence intensity and line shape of the spectra from lesions were compared with the same parameters from the contralateral control site in the same individual. Setting: Otolaryngology Research Center, Department of Otolaryngology–Head and Neck Surgery, New England Medical Center, Boston, Mass. Results: The ratio of peak fluorescence intensities of the neoplastic lesions to contralateral normal control mucosa were consistently different compared with these ratios in benign lesions or normal mucosa. These differences were seen in 2 distinct regions of the fluorescence spectrum with both of the excitation wavelengths, but were more obvious with the excitation wavelength of 410 nm. Using these differences, we were able to correctly diagnose 17 of the 19 lesions studied, with 2 false-positive results. Conclusions: Neoplastic oral mucosa shows consistent differences in autofluorescence spectral intensity and line shape when compared with the normal mucosa in the same individual. These early results show that fluorescence spectroscopy may represent a useful technique for noninvasive early diagnosis of cancer of the upper aerodigestive tract.Arch Otolaryngol Head Neck Surg. 1996;122:1181-1186 References 1. Bouquot JE, Gnepp DR. Epidemiology of carcinoma in situ of the upper aerodigestive tract . Cancer . 1988;61:1685-1690.Crossref 2. Daftary DK, Murti PR, Bhonsle RB, et al. Risk factors and risk markers for oral cancer in high risk areas of the world . In: Johnson NW, ed. Oral Cancer: Detection of Patients and Lesions at Risk . Cambridge, England: Cambridge University Press; 1991:29-63. 3. Slaughter DL, Southwick HW, Smejkal W. 'Field cancerization' in oral stratified squamous epithelium: clinical implications of multicentric origin . Cancer . 1953; 6:963-968.Crossref 4. Alfano RR, Tata DB, Cordero J, Tomashefsky P, Longo FW, Alfano MA. Laser induced fluorescence spectroscopy from native cancerous and normal tissue . IEEE J Quant Elect . 1984;20:1507-1511.Crossref 5. Bert L, Berg R, Van Dame B, et al. Clinical fluorescence diagnosis of human bladder carcinoma following low-dose Photofrin injection . Urology . 1993;41: 322-330.Crossref 6. Braginskaja OV, Lazarev W, Polsachev VI, Rubin LB, Stoskii VE. Fluorescent diagnostics of human gastric cancer and sodium fluorescein accumulation in experimental gastric cancer in rats . Cancer Lett . 1993;69:117-121.Crossref 7. Cothren RM, Richards-Kortum R, Sivak MV Jr, et al. Gastrointestinal tissue diagnosis by laser-induced fluorescence spectroscopy at endoscopy . Gastrointest Endosc . 1990;36:105-111.Crossref 8. Schomacker KT, Frisoli JK, Compton CC, et al. Ultraviolet laser-induced fluorescence of colonic tissue: basic biology and diagnostic potential . Lasers Surg Med . 1992;12:63-78.Crossref 9. Lam S, Hung JY, Kennedy SM, et al. Detection of dysplasia and carcinoma in situ by ratio fluorometry . Am Rev Respir Dis . 1992;146:1458-1461.Crossref 10. Richards-Kortum R, Mitchell MF, Ramanujam N, Mahadevan A, Thomsen S. In vivo fluorescence spectroscopy: potential for non-invasive, automated diagnosis of cervical intraepithelial neoplasia and use as a surrogate endpoint biomarker . J Cell Biochem Suppl . 1994;19:111-119. 11. Ingrams DR, Dhingra JK, Roy K, et al. Autofluorescence characteristics of oral mucosa. Head Neck. In press. 12. Kolli VR, Savage HE, Schantz SP. Native cellular fluorescence of neoplastic aerodigestive tract mucosa . Arch Otolaryngol Head Neck Surg . 1995;121:1287-1292.Crossref 13. Rittenhouse-Diakun K, Van Leengoed H, Morgan J, et al. The role of transferrin receptor (CD 71) in photodynamic therapy of activated and malignant lymphocytes using the heme precursor delta-aminolevulinic acid (ALA) . Photochem Photobiol 1995;61:523-528.Crossref 14. Zonios GI, Cothren RM, Arendt JT, et al. Morphological model of human colon tissue fluorescence . IEEE Trans Biomed Eng . 1996;43:113-122.Crossref 15. Zângaro RA, Silveira L Jr, Manoharan R, et al. Rapid multi-excitation fluorescence system for in vivo tissue diagnosis . Appl Optics . 1996;35:5211-5219.Crossref 16. Harris DM, Werkhaven J. Endogenous porphyrin fluorescence in tumors . Lasers Surg Med . 1987;7:467-472.Crossref 17. Rasetti L, Rubino GF, Drago W. Ferrochelatase, ALA-dehydrase and ALAsynthetase activity in human tumour tissue . Panminerva Med . 1967;9:132-135. 18. Leibovici NILI, Schoenfeld HA, Yehoshua R, et al. Activity of porphobilinogen deaminase in peripheral blood mononuclear cells of patients with metastatic cancer . Cancer . 1988;62:2297-2300.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.1996.01890230029007
Publisher site
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Abstract

Abstract Objective: To explore the potential of autofluorescence spectroscopy as a tool for early detection of upper aerodigestive tract cancer. Design: Autofluorescence spectral characteristics of 19 untreated oral and oropharyngeal lesions in 13 patients were studied with excitation wavelengths of 370 and 410 nm generated by a nitrogen pumped dye laser. Ten healthy volunteers were recruited to characterize the fluorescence spectra of normal mucosa at different oral sites and to study individual variations. Fluorescence intensity and line shape of the spectra from lesions were compared with the same parameters from the contralateral control site in the same individual. Setting: Otolaryngology Research Center, Department of Otolaryngology–Head and Neck Surgery, New England Medical Center, Boston, Mass. Results: The ratio of peak fluorescence intensities of the neoplastic lesions to contralateral normal control mucosa were consistently different compared with these ratios in benign lesions or normal mucosa. These differences were seen in 2 distinct regions of the fluorescence spectrum with both of the excitation wavelengths, but were more obvious with the excitation wavelength of 410 nm. Using these differences, we were able to correctly diagnose 17 of the 19 lesions studied, with 2 false-positive results. Conclusions: Neoplastic oral mucosa shows consistent differences in autofluorescence spectral intensity and line shape when compared with the normal mucosa in the same individual. These early results show that fluorescence spectroscopy may represent a useful technique for noninvasive early diagnosis of cancer of the upper aerodigestive tract.Arch Otolaryngol Head Neck Surg. 1996;122:1181-1186 References 1. Bouquot JE, Gnepp DR. Epidemiology of carcinoma in situ of the upper aerodigestive tract . Cancer . 1988;61:1685-1690.Crossref 2. Daftary DK, Murti PR, Bhonsle RB, et al. Risk factors and risk markers for oral cancer in high risk areas of the world . In: Johnson NW, ed. Oral Cancer: Detection of Patients and Lesions at Risk . Cambridge, England: Cambridge University Press; 1991:29-63. 3. Slaughter DL, Southwick HW, Smejkal W. 'Field cancerization' in oral stratified squamous epithelium: clinical implications of multicentric origin . Cancer . 1953; 6:963-968.Crossref 4. Alfano RR, Tata DB, Cordero J, Tomashefsky P, Longo FW, Alfano MA. Laser induced fluorescence spectroscopy from native cancerous and normal tissue . IEEE J Quant Elect . 1984;20:1507-1511.Crossref 5. Bert L, Berg R, Van Dame B, et al. Clinical fluorescence diagnosis of human bladder carcinoma following low-dose Photofrin injection . Urology . 1993;41: 322-330.Crossref 6. Braginskaja OV, Lazarev W, Polsachev VI, Rubin LB, Stoskii VE. Fluorescent diagnostics of human gastric cancer and sodium fluorescein accumulation in experimental gastric cancer in rats . Cancer Lett . 1993;69:117-121.Crossref 7. Cothren RM, Richards-Kortum R, Sivak MV Jr, et al. Gastrointestinal tissue diagnosis by laser-induced fluorescence spectroscopy at endoscopy . Gastrointest Endosc . 1990;36:105-111.Crossref 8. Schomacker KT, Frisoli JK, Compton CC, et al. Ultraviolet laser-induced fluorescence of colonic tissue: basic biology and diagnostic potential . Lasers Surg Med . 1992;12:63-78.Crossref 9. Lam S, Hung JY, Kennedy SM, et al. Detection of dysplasia and carcinoma in situ by ratio fluorometry . Am Rev Respir Dis . 1992;146:1458-1461.Crossref 10. Richards-Kortum R, Mitchell MF, Ramanujam N, Mahadevan A, Thomsen S. In vivo fluorescence spectroscopy: potential for non-invasive, automated diagnosis of cervical intraepithelial neoplasia and use as a surrogate endpoint biomarker . J Cell Biochem Suppl . 1994;19:111-119. 11. Ingrams DR, Dhingra JK, Roy K, et al. Autofluorescence characteristics of oral mucosa. Head Neck. In press. 12. Kolli VR, Savage HE, Schantz SP. Native cellular fluorescence of neoplastic aerodigestive tract mucosa . Arch Otolaryngol Head Neck Surg . 1995;121:1287-1292.Crossref 13. Rittenhouse-Diakun K, Van Leengoed H, Morgan J, et al. The role of transferrin receptor (CD 71) in photodynamic therapy of activated and malignant lymphocytes using the heme precursor delta-aminolevulinic acid (ALA) . Photochem Photobiol 1995;61:523-528.Crossref 14. Zonios GI, Cothren RM, Arendt JT, et al. Morphological model of human colon tissue fluorescence . IEEE Trans Biomed Eng . 1996;43:113-122.Crossref 15. Zângaro RA, Silveira L Jr, Manoharan R, et al. Rapid multi-excitation fluorescence system for in vivo tissue diagnosis . Appl Optics . 1996;35:5211-5219.Crossref 16. Harris DM, Werkhaven J. Endogenous porphyrin fluorescence in tumors . Lasers Surg Med . 1987;7:467-472.Crossref 17. Rasetti L, Rubino GF, Drago W. Ferrochelatase, ALA-dehydrase and ALAsynthetase activity in human tumour tissue . Panminerva Med . 1967;9:132-135. 18. Leibovici NILI, Schoenfeld HA, Yehoshua R, et al. Activity of porphobilinogen deaminase in peripheral blood mononuclear cells of patients with metastatic cancer . Cancer . 1988;62:2297-2300.Crossref

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Nov 1, 1996

References