Aboumarzouk Omar, Valentine Ronan, Buist Ron, Ahmad Sarfraz, Nabi Ghulam, Eljamel Sam, Moseley Harry, Kata Slawomir Grzegorz
Department of Urology, Ninewells Hospital and Medical School, Dundee, UK; Department of Urology, Royal Gwent Hospital, Newport, Wales, UK; Islamic Universities of Gaza, College of Medicine, Gaza, Palestine.
The Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee, UK; The Scottish Photodynamic Therapy Centre, Ninewells Hospital & Medical School, Dundee, UK.
Photodiagnosis Photodyn Ther. 2015 Mar;12(1):76-83. doi: 10.1016/j.pdpdt.2014.12.003. Epub 2015 Jan 3.
Non-muscle invasive bladder cancer can be missed during white light endoscopy in up to 50% of cases. We aimed to test whether or not we could find a difference between benign and cancerous tissue wavelengths using laser induced autofluorescence spectroscopy can increase cancer detection.
We analysed 67 tissue samples using spectral analysis. The WavSTAT (Spectra Science) optical biopsy device was used to record fluorescence spectra from biopsied tissue enabling calculation of an AUC for each spectrum, a measure of the mean spectral wavelength (λ¯ (nm)) and a dimensionless fluorescence ratio. Mann-Whitney test was used to compare the two groups.
We found that 49.3% (33/67) of the tissue was benign, 44.8% (30/67) was CIS/cancerous tissue, and the remaining 4/67 samples were atypia (2) and dysplasia (2). The median AUC for the benign tissue was 19.53 (interquartile range [IQR]: 5.35-30.39) and that for CIS/cancerous tissue was 7.05 (IQR: 2.89-14.24) (P=0.002). The median wavelengths for the benign tissue and malignant tissue were 502.4nm (IQR: 500.3-504.3nm) and 505.2nm (IQR: 502.1-513.2nm), respectively (P=0.003). The median fluorescence ratio was 0.080 (IQR: 0.070-0.088) for benign tissue and 0.096 (IQR: 0.079-0.221) for CIS/cancerous tissue (P=0.002).
We found statistical differences between the median AUC calculations and median wavelengths for the benign and cancerous tissue. We also found a statistical difference between the fluorescence ratios between the two tissue types. There seems to be a role for optical spectroscopy in verifying bladder lesions.
在白光内镜检查中，高达50%的非肌层浸润性膀胱癌病例可能被漏诊。我们旨在测试使用激光诱导自体荧光光谱法能否发现良性组织与癌组织波长之间的差异，从而提高癌症检测率。
我们使用光谱分析对67个组织样本进行了分析。使用WavSTAT（光谱科学）光学活检设备记录活检组织的荧光光谱，从而计算每个光谱的AUC、平均光谱波长（λ¯（nm））的测量值以及无量纲荧光比率。采用曼-惠特尼检验对两组进行比较。
我们发现49.3%（33/67）的组织为良性，44.8%（30/67）为原位癌/癌组织，其余4/67个样本为非典型增生（2个）和发育异常（2个）。良性组织的AUC中位数为19.53（四分位间距[IQR]：5.35 - 30.39），原位癌/癌组织的AUC中位数为7.05（IQR：2.89 - 14.24）（P = 0.002）。良性组织和恶性组织的波长中位数分别为502.4nm（IQR：500.3 - 504.3nm）和505.2nm（IQR：502.1 - 513.2nm）（P = 0.003）。良性组织的荧光比率中位数为0.080（IQR：0.070 - 0.088），原位癌/癌组织的荧光比率中位数为0.096（IQR：0.079 - 0.221）（P = 0.002）。
我们发现良性组织与癌组织的AUC中位数计算值和波长中位数之间存在统计学差异。我们还发现两种组织类型的荧光比率之间存在统计学差异。光谱学似乎在膀胱病变的验证中具有一定作用。
