Evaluation of in vivo endoscopic autofluorescence spectroscopy in gastric cancer
Evaluation of in vivo endoscopic autofluorescence spectroscopy in gastric cancer
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DOI：
10.1016/s0016-5107(03)02687-7
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发表时间：
2004-02-01
影响因子：
7.7
通讯作者：
Hahn, EG
中科院分区：
文献类型：
--
作者：
Mayinger, B;Jordan, M;Hahn, EG
背景本研究的目的是评估光诱导自体荧光光谱在体内诊断胃癌cancer.Methods：共344内源性荧光光谱获得正常（164）和癌胃粘膜（180）在15例纯腺癌和16例胃癌印戒细胞。使用能够通过内窥镜传递白色或紫蓝色光以激发组织自体荧光的特殊光源。结果：胃腺癌组织与正常胃粘膜组织相比，其内源性荧光光谱发生了特异性变化。通过光谱的算法分类，获得了诊断纯胃腺癌的灵敏度为84%，特异性为87%，阳性试验的似然比为6.5，阴性试验的似然比为0.18。然而，与正常粘膜相比，具有印戒细胞的胃癌在发射的自体荧光光谱中表现出很大的变化。所有含有印戒细胞的癌的诊断敏感性为55%，特异性为85%，阳性试验的似然比为3.7，阴性试验的似然比为0.53。结论：光诱导自体荧光光谱是一种新的生物光学技术，可用于胃腺癌的内镜活体诊断。印戒细胞癌的诊断准确性较差，这可能是由于这种肿瘤的弥漫性和频繁的粘膜下生长以及胶原纤维的存在。
Background. The aim of this study was to evaluate light-induced autofluorescence spectroscopy for the in vivo diagnosis of gastric cancer.Methods: A total of 344 endogenous fluorescence spectra were obtained from normal (164) and cancerous gastric mucosa (180) in 15 patients with pure adenocarcinoma and in 16 patients with gastric cancer containing signet-ring cells. A special light source capable of delivering either white or violet-blue light for the excitation of tissue autofluorescence via the endoscope was used. Endogenous fluorescence spectra emitted by the tissue were collected with a fiberoptic probe and analyzed with a spectrograph.Results: Gastric adenocarcinoma exhibits specific changes in the emitted fluorescence spectra as compared with normal gastric mucosa. By algorithmic classification of the spectra, a sensitivity of 84%, specificity of 87%, a likelihood ratio for a positive test of 6.5 and for a negative test of 0.18 were obtained for the diagnosis of pure adenocarcinoma of the stomach. However, gastric cancer with signet-ring cells exhibits great variation in emitted autofluorescence spectra as compared with normal mucosa. The sensitivity for the diagnosis of all carcinomas containing signet-ring cells was 55%, specificity 85%, the likelihood ratio for a positive test was 3.7 and for a negative test, 0.53. The diagnostic value decreases with increasing numbers of signet-ring cells and tumor grade.Conclusions: Light-induced autofluorescence spectroscopy is a new and promising bio-optical technique for the endoscopic in vivo diagnosis of gastric adenocarcinoma. The poor diagnostic accuracy for signet-ring cell carcinoma may be explained by the diffuse and frequent submucosal growth of this tumor and the presence of collagen fibers.