Schwarz Richard A, Gao Wen, Redden Weber Crystal, Kurachi Cristina, Lee J Jack, El-Naggar Adel K, Richards-Kortum Rebecca, Gillenwater Ann M
Department of Bioengineering, Rice University, Houston, Texas, USA.
Cancer. 2009 Apr 15;115(8):1669-79. doi: 10.1002/cncr.24177.
Optical spectroscopy is a noninvasive technique with potential applications for diagnosis of oral dysplasia and early cancer. In this study, we evaluated the diagnostic performance of a depth-sensitive optical spectroscopy (DSOS) system for distinguishing dysplasia and carcinoma from non-neoplastic oral mucosa.
Patients with oral lesions and volunteers without any oral abnormalities were recruited to participate. Autofluorescence and diffuse reflectance spectra of selected oral sites were measured using the DSOS system. A total of 424 oral sites in 124 subjects were measured and analyzed, including 154 sites in 60 patients with oral lesions and 270 sites in 64 normal volunteers. Measured optical spectra were used to develop computer-based algorithms to identify the presence of dysplasia or cancer. Sensitivity and specificity were calculated using a gold standard of histopathology for patient sites and clinical impression for normal volunteer sites.
Differences in oral spectra were observed in: (1) neoplastic versus nonneoplastic sites, (2) keratinized versus nonkeratinized tissue, and (3) shallow versus deep depths within oral tissue. Algorithms based on spectra from 310 nonkeratinized anatomic sites (buccal, tongue, floor of mouth, and lip) yielded an area under the receiver operating characteristic curve of 0.96 in the training set and 0.93 in the validation set.
The ability to selectively target epithelial and shallow stromal depth regions appeared to be diagnostically useful. For nonkeratinized oral sites, the sensitivity and specificity of this objective diagnostic technique were comparable to that of clinical diagnosis by expert observers. Thus, DSOS has potential to augment oral cancer screening efforts in community settings.
光学光谱学是一种非侵入性技术，在口腔发育异常和早期癌症的诊断方面具有潜在应用价值。在本研究中，我们评估了深度敏感光学光谱学（DSOS）系统在区分发育异常和癌与非肿瘤性口腔黏膜方面的诊断性能。
招募有口腔病变的患者和无任何口腔异常的志愿者参与。使用DSOS系统测量选定口腔部位的自体荧光和漫反射光谱。对124名受试者的424个口腔部位进行了测量和分析，包括60名口腔病变患者的154个部位和64名正常志愿者的270个部位。利用测得的光谱开发基于计算机的算法，以识别发育异常或癌症的存在。使用患者部位的组织病理学金标准和正常志愿者部位的临床印象计算敏感性和特异性。
观察到口腔光谱在以下方面存在差异：（1）肿瘤性与非肿瘤性部位；（2）角化组织与非角化组织；（3）口腔组织内的浅层与深层。基于来自310个非角化解剖部位（颊、舌、口底和唇）光谱的算法在训练集中的受试者操作特征曲线下面积为0.96，在验证集中为0.93。
选择性靶向上皮和浅层基质深度区域的能力似乎具有诊断价值。对于非角化口腔部位，这种客观诊断技术的敏感性和特异性与专家观察者的临床诊断相当。因此，DSOS有潜力增强社区环境中的口腔癌筛查工作。
