Native cellular fluorescence of neoplastic upper aerodigestive mucosa.

OBJECTIVE

To identify alterations in the biochemical composition and histoarchitectural structure of the lining epithelium that signal malignant transformation in carcinogen-exposed upper aerodigestive mucosa by quantitation of native cellular fluorescent properties.

DESIGN

Case series.

SETTING

Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY.

PATIENTS AND METHODS

Thirty-one patients with previously untreated mucosal neoplasias of the oral cavity and pharynx were studied by means of a hand-held fiberoptic probe attached to a xenon lamp-based fluorescent spectrometer. Fluorescence analyses of the lesions and contralateral normal sites were performed in each patient on the basis of specific emission and excitation wavelengths. Differences between normal tissue and neoplastic mucosa were tested for statistical significance by paired t test and Hotelling's T2 test.

RESULTS

The ratios of fluorescence intensities of neoplastic mucosa and contralateral normal sites were significantly different in three of the four fluorescence scans (excitation of 300 nm and emission of 320 to 580 nm; excitation of 340 nm and emission of 360 to 660 nm; and excitation of 200 to 360 nm and emission of 380 nm) when analyzed individually (P < .05). The ratios in the scans with excitation of 240 to 430 nm and emission of 450 nm were not significantly different. All four scans, when analyzed together, demonstrated significant differences between normal and neoplastic tissues (P < .01).

CONCLUSIONS

Neoplastic mucosa of the upper aerodigestive tract within an individual patient will express native cellular fluorescent properties in vivo that differ from those of normal upper aerodigestive epithelia. This may represent a noninvasive screening method for head and neck squamous cell cancers.