Mahadevan A, Mitchell M F, Silva E, Thomsen S, Richards-Kortum R R
Biomedical Engineering Program, University of Texas, Austin 78712.
Lasers Surg Med. 1993;13(6):647-55. doi: 10.1002/lsm.1900130609.
Fluorescence excitation-emission matrices (EEMs) were obtained in vitro for 18 cervical biopsies from 10 patients. At all excitation emission maxima, but especially at 330 nm excitation, 385 nm emission, the average normalized fluorescence intensity of histologically normal tissue is greater statistically than that of histologically abnormal tissue. A diagnostic algorithm based on the relative intensity at 330 nm excitation, 385 nm emission can differentiate histologically normal and abnormal biopsies with a higher sensitivity (89%), but a lower positive predictive value (67%) and specificity (44%) than colposcopy (78%, 88%, 89%, respectively). However, paired comparison of histologically normal and abnormal biopsies from the same patient results in a sensitivity of 75%, positive predictive value of 86% and specificity of 88% for spectroscopic identification of histologic abnormality similar to that of colposcopy. This pilot study indicates that fluorescence spectroscopy may be useful in differentiating normal and abnormal tissue; based on these results, a strategy for in vivo studies is discussed.
对10名患者的18份宫颈活检样本进行了体外荧光激发-发射矩阵（EEM）测定。在所有激发发射最大值处，尤其是在330nm激发、385nm发射时，组织学正常组织的平均归一化荧光强度在统计学上高于组织学异常组织。基于330nm激发、385nm发射时的相对强度的诊断算法可区分组织学正常和异常活检样本，其灵敏度较高（89%），但阳性预测值（67%）和特异性（44%）低于阴道镜检查（分别为78%、88%、89%）。然而，对同一患者的组织学正常和异常活检样本进行配对比较，光谱识别组织学异常的灵敏度为75%，阳性预测值为86%，特异性为88%，与阴道镜检查相似。这项初步研究表明，荧光光谱法可能有助于区分正常组织和异常组织；基于这些结果，讨论了体内研究策略。
