A comparative study of normal inspection, autofluorescence and 5-ALA-induced PPIX fluorescence for oral cancer diagnosis
A comparative study of normal inspection, autofluorescence and 5-ALA-induced PPIX fluorescence for oral cancer diagnosis
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DOI：
10.1002/ijc.1596
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发表时间：
2002-01-10
影响因子：
6.4
通讯作者：
Leunig, A
中科院分区：
文献类型：
--
作者：
Betz, CS;Stepp, H;Leunig, A
荧光诊断旨在通过早期发现恶性病变和更好地划定肿瘤边缘来改善口腔癌的管理。本文对常规检查、联合荧光诊断（CFD）及其两种主要成分：自体荧光和5-氨基乙酰丙酸（5-ALA）诱导的原卟啉IX（PPIX）荧光进行了比较研究。在局部施用S-ALA（200 mg 5-ALA溶解于50 ml H2O中）之前和之后，对总共85名疑似或经组织学证实的口腔癌患者进行活检控制的荧光成像和光谱分析。使用氙短弧灯（λ = 375-440 nm）的过滤光实现荧光激发。对于CFD，在所获取的图像上，在恶性组织和健康组织之间容易发现“街灯”对比（红色到绿色）。在肿瘤定位和定界属性方面，CFD明显优于正常检查或其2个荧光成像组件。CFD的性能被认为是肿瘤角化的阻碍，但独立于肿瘤分期，分级或定位。在光谱分析中，癌组织表现出显着较高的PPIX荧光强度和较低的自发荧光强度比正常粘膜。CFD在口腔肿瘤的早期检测和肿瘤浅表边缘的精确界定方面具有巨大的潜力，并且优于白色光检查及其2个主要组成部分。该方法具有无创、安全、重复性好等优点。(C)2002 Wiley-Liss，Inc.
Fluorescence diagnosis aims to improve the management of oral cancer via early detection of the malignant lesions and better delimitation of the tumor margins. This paper presents a comparative study of normal inspection, combined fluorescence diagnosis (CFD) and its 2 main components, autofluorescence and 5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PPIX) fluorescence. Biopsy-controlled fluorescence imaging and spectral analysis were performed on a total of 85 patients with suspected or histologically proven oral carcinoma both before and after topical administration of S-ALA (200 mg 5-ALA dissolved in 50 ml of H2O). Fluorescence excitation was accomplished using filtered light of a xenon short arc lamp (lambda = 375-440 nm). As for CFD, a "streetlight" contrast (red to green) was readily found between malignant and healthy tissue on the acquired images. In terms of tumor localization and delimitation properties, CFD was clearly favorable over either normal inspection or its 2 components in fluorescence imaging. The performance of CFD was found to be impeded by tumor keratinization but to be independent of either tumor staging, grading or localization. In spectral analysis, cancerous tissue showed significantly higher PPIX fluorescence intensities and lower autofluorescence intensities than normal mucosa. There is a great potential for CFD in early detection of oral neoplasms and exact delimitation of the tumors' superficial margins and an advantage over white light inspection and each of its 2 main components. The method is noninvasive, safe and easily reproducible. (C) 2002 Wiley-Liss, Inc.