George Ronie, Michaelides Michalis, Brewer Molly A, Utzinger Urs
College of Optical Sciences, University of Arizona, Tucson, Arizona 85721, USA.
Lasers Surg Med. 2012 Apr;44(4):282-95. doi: 10.1002/lsm.22014. Epub 2012 Mar 7.
Endogenous fluorescence from certain amino acids, structural proteins, and enzymatic co-factors in tissue is altered by carcinogenesis. We evaluate the potential of these changes in fluorescence to predict a diagnosis of malignancy and to estimate the risk of developing ovarian cancer.
STUDY DESIGN/MATERIALS AND METHODS: Ovarian biopsies were interrogated over 270-550 nm excitation and fluorescence was collected from 290 to 700 nm. Two hundred forty-nine measurements were performed on 49 IRB-consented patients undergoing oophorectomy. Data are analyzed using parallel factor analysis to determine excitation and emission spectra of the underlying fluorophores that contribute to the total detected fluorescence intensity.
Using multivariate normal distribution fits and cross-validation techniques, sensitivity and specificity of 88% and 93%, respectively, are achieved when classifying malignant samples versus others, while 88% and 80%, respectively, are achieved when classifying normal post-menopausal patients as being either at high- or low-risk of developing ovarian cancer based on their personal and family history of cancer. Performance of classifying cancer increases when the normal group does not include benign neoplasm and endometriosis samples. Performance of high- versus low-risk classification decreases when normal samples include both pre- and post-menopausal women. Excitation over 270-400 and 380-560 nm, respectively, have the best diagnostic performance for cancer detection and risk-status assessment.
Assessing the endogenous fluorescence could be useful in screening women at increased risk of developing ovarian cancer.
组织中某些氨基酸、结构蛋白和酶辅助因子的内源性荧光会因癌变而改变。我们评估这些荧光变化在预测恶性肿瘤诊断以及估计患卵巢癌风险方面的潜力。
研究设计/材料与方法：对卵巢活检组织在270 - 550nm激发波长下进行检测，并收集290至700nm的荧光。对49名经机构审查委员会（IRB）批准同意接受卵巢切除术的患者进行了249次测量。使用平行因子分析对数据进行分析，以确定构成总检测荧光强度的潜在荧光团的激发光谱和发射光谱。
使用多元正态分布拟合和交叉验证技术，在将恶性样本与其他样本分类时，灵敏度和特异性分别达到88%和93%；而根据个人和家族癌症病史将绝经后正常患者分类为患卵巢癌高风险或低风险时，灵敏度和特异性分别为88%和80%。当正常组不包括良性肿瘤和子宫内膜异位症样本时，癌症分类的性能会提高。当正常样本包括绝经前和绝经后女性时，高风险与低风险分类的性能会降低。分别在270 - 400nm和380 - 560nm激发下，对癌症检测和风险状态评估具有最佳诊断性能。
评估内源性荧光可能有助于筛查患卵巢癌风险增加的女性。
