Ramanujam N, Mitchell M F, Mahadevan A, Thomsen S, Malpica A, Wright T, Atkinson N, Richards-Kortum R
Biomedical Engineering Program, University of Texas, Austin 78705, USA.
Lasers Surg Med. 1996;19(1):63-74. doi: 10.1002/(SICI)1096-9101(1996)19:1<63::AID-LSM8>3.0.CO;2-O.
The diagnostic contribution of cervical tissue fluorescence spectra acquired in vivo at 380 and 460 nm excitation were analyzed using a general multivariate statistical algorithm.
The primary steps of the algorithm are to: (1) preprocess data to reduce interpatient and intrapatient variation of tissue spectra from the same diagnostic category, without a priori information, (2) dimensionally reduce the pre-processed spectral data using Principal Component Analysis, and (3) develop a probability based classification scheme based on logistic discrimination using the diagnostically useful principal components. The algorithm was tested on cervical tissue spectra acquired from 165 sites at 380 nm excitation and from 147 sites at 460 nm excitation. A retrospective and prospective estimate of the algorithm's performance was determined.
At 460 nm excitation, (1) SILs can be differentiated from normal squamous tissues with an average sensitivity and specificity of 91% +/- 1.3 and 75.5% +/- 1, respectively; furthermore, (2) high grade SILs can be differentiated from low grade SILs with an average sensitivity and specificity of 80% +/- 4 and 76% +/- 5, respectively. In addition, using tissue spectra at 380 nm excitation, SILs can be differentiated from normal columnar epithelia and inflammation with an average sensitivity and specificity of 77% +/- 1 and 72% +/- 9, respectively.
Fluorescence spectra at multiple excitation wavelengths are essential for the detection and differential diagnosis of SILs at colposcopy.
使用一种通用的多元统计算法分析了在380和460 nm激发波长下体内采集的宫颈组织荧光光谱的诊断价值。
该算法的主要步骤为：（1）对数据进行预处理，以减少同一诊断类别中患者间和患者内组织光谱的差异，无需先验信息；（2）使用主成分分析对预处理后的光谱数据进行降维；（3）基于逻辑判别，利用具有诊断价值的主成分开发基于概率的分类方案。该算法在380 nm激发波长下从165个部位采集的宫颈组织光谱以及460 nm激发波长下从147个部位采集的宫颈组织光谱上进行了测试。对该算法的性能进行了回顾性和前瞻性评估。
在460 nm激发波长下，（1）可将鳞状上皮内病变（SILs）与正常鳞状组织区分开，平均灵敏度和特异度分别为91%±1.3和75.5%±1；此外，（2）可将高级别SILs与低级别SILs区分开，平均灵敏度和特异度分别为80%±4和76%±5。另外，使用380 nm激发波长下的组织光谱，可将SILs与正常柱状上皮和炎症区分开，平均灵敏度和特异度分别为77%±1和72%±9。
多个激发波长下的荧光光谱对于阴道镜检查中SILs的检测和鉴别诊断至关重要。
