Schomacker K T, Frisoli J K, Compton C C, Flotte T J, Richter J M, Nishioka N S, Deutsch T F
Wellman Laboratories, Massachusetts General Hospital, Boston 02114.
Lasers Surg Med. 1992;12(1):63-78. doi: 10.1002/lsm.1900120111.
Laser-induced fluorescence (LIF) of colonic tissue was examined both in vitro and in vivo to assess the ability of the technique to distinguish neoplastic from hyperplastic and normal tissue and to relate the LIF spectra to specific constituents of the colon. Spectra from 86 normal colonic sites, 35 hyperplastic polyps, 49 adenomatous polyps, and 7 adenocarcinomas were recorded both in vivo and in vitro. With 337-nm excitation, the fluorescence spectra all had peaks at 390 and 460 nm, believed to arise from collagen and NADH, and a minimum at 425 nm, consistent with absorption attributable to hemoglobin. The spectra of colonic tissue recorded both in vivo and in vitro are different, primarily in the NADH fluorescence component, which decays exponentially with time after resection. When normal colonic tissue is compared to hyperplastic or adenomatous polyps, the predominant changes in the fluorescence spectra are a decrease in collagen fluorescence and a slight increase in hemoglobin reabsorption. A multivariate linear regression (MVLR) analysis was used to distinguish neoplastic tissue from non-neoplastic tissue with a sensitivity, specificity, predictive value positive, and predictive value negative toward neoplastic tissue of 80%, 92%, 82%, and 91%, respectively. When the MVLR technique was used to distinguish neoplastic polyps from non-neoplastic polyps, values of 86%, 77%, 86%, and 77% respectively, were obtained. The data suggest that the LIF measurements sense changes in polyp morphology, rather than changes in fluorophores specific to polyps, and it is this change in morphology that leads indirectly to discrimination of polyps.
对结肠组织的激光诱导荧光（LIF）进行了体外和体内检测，以评估该技术区分肿瘤组织与增生性及正常组织的能力，并将LIF光谱与结肠的特定成分相关联。记录了86个正常结肠部位、35个增生性息肉、49个腺瘤性息肉和7个腺癌在体内和体外的光谱。在337nm激发下，荧光光谱在390和460nm处均有峰值，据信分别源于胶原蛋白和烟酰胺腺嘌呤二核苷酸（NADH），在425nm处有最小值，这与血红蛋白的吸收一致。体内和体外记录的结肠组织光谱不同，主要体现在NADH荧光成分上，其在切除后随时间呈指数衰减。当将正常结肠组织与增生性或腺瘤性息肉进行比较时，荧光光谱的主要变化是胶原蛋白荧光减少以及血红蛋白重吸收略有增加。采用多元线性回归（MVLR）分析来区分肿瘤组织与非肿瘤组织，对肿瘤组织的敏感性、特异性、阳性预测值和阴性预测值分别为80%、92%、82%和91%。当使用MVLR技术区分肿瘤性息肉与非肿瘤性息肉时，相应的值分别为86%、77%、86%和77%。数据表明，LIF测量感知的是息肉形态的变化，而非息肉特有的荧光团的变化，正是这种形态变化间接导致了息肉的鉴别。
