Kawakami-Wong Hilari, Gu Shuguang, Hammer-Wilson Marie J, Epstein Joel B, Chen Zhongping, Wilder-Smith Petra
University of California, Irvine, Beckman Laser Institute, 1002 Health Sciences Road East, Irvine, California 92612, USA.
J Biomed Opt. 2007 Sep-Oct;12(5):051702. doi: 10.1117/1.2779025.
A preliminary study to assess noninvasive optical coherence tomography (OCT) for early detection and evaluation of chemotherapy-induced oral mucositis in five patients. In five patients receiving neoadjuvant chemotherapy for primary breast cancer, oral mucositis was assessed clinically, and imaged using noninvasive OCT. Imaging was scored using a novel imaging-based scoring system. Conventional clinical assessment using the Oral Mucositis Assessment Scale was used as the gold standard. Patients were evaluated on days 0, 2, 4, 7, and 11 after commencement of chemotherapy. OCT images were visually examined by one blinded investigator. The following events were identified using OCT: (1) change in epithelial thickness and subepithelial tissue integrity (beginning on day 2), (2) loss of surface keratinized layer continuity (beginning on day 4), (3) loss of epithelial integrity (beginning on day 4). Imaging data gave higher scores compared to clinical scores earlier in treatment, suggesting that the imaging-based diagnostic scoring was more sensitive to early mucositic change than the clinical scoring system. Once mucositis was established, imaging and clinical scores converged. Chemotherapy-induced oral changes were identified prior to their clinical manifestation using OCT, and the proposed scoring system for oral mucositis was validated for the semiquantification of mucositic change.
一项评估无创光学相干断层扫描（OCT）用于早期检测和评估5例患者化疗引起的口腔黏膜炎的初步研究。在5例接受原发性乳腺癌新辅助化疗的患者中，对口腔黏膜炎进行临床评估，并使用无创OCT成像。使用一种新的基于成像的评分系统对图像进行评分。以使用口腔黏膜炎评估量表进行的传统临床评估作为金标准。在化疗开始后的第0、2、4、7和11天对患者进行评估。由一名盲法研究者对OCT图像进行视觉检查。使用OCT识别出以下情况：（1）上皮厚度和上皮下组织完整性的变化（从第2天开始），（2）表面角质化层连续性丧失（从第4天开始），（3）上皮完整性丧失（从第4天开始）。与治疗早期的临床评分相比，成像数据给出的分数更高，这表明基于成像的诊断评分比临床评分系统对早期黏膜炎变化更敏感。一旦黏膜炎确诊，成像和临床评分趋于一致。使用OCT在化疗引起的口腔变化临床表现之前就识别出来了，并且所提出的口腔黏膜炎评分系统被验证可用于黏膜炎变化的半定量。
