Infrared Microspectroscopy for Cervical Cancer Screening

描述（由申请人提供）：本提案旨在将红外显微光谱（IR-MSP）确立为一种比目前使用的方法更快、更便宜、更客观和更准确的宫颈发育不良检测技术。宫颈疾病的筛查目前通过细胞学程序（Papanicolaou，或“Pap”测试）进行，该方法于20世纪40年代末首次提出[Papanicolaou，1948]。尽管定期使用巴氏试验进行妇科筛查大大降低了宫颈癌的发病率和死亡率，但仍然存在相对较高的不准确或不确定的诊断率[美国卫生与公众服务部，1989]。经典细胞学是一种基于定位和识别具有改变的形态的细胞作为疾病指标的视觉检查方法。形态学变化是细胞突变的结果。虽然好 这种方法的缺点是，对形态变化的解释是以人为本的，因此本质上是主观的。此外，操作者疲劳、培训和经验影响细胞学检查的质量、可靠性和再现性。 诊断。为了减轻视觉检测的固有局限性，在过去的十年中，已经开发和利用了基于计算机的成像技术检测。然而，基于计算机的图像分析并没有显着提高可靠性 的诊断，并没有证明成本效益[哈钦森，1996]。 IR-MSP是一种新技术，其通过检测细胞组成及其变化来识别异常，而不是通过检测细胞组成及其变化来识别异常。 通过形态特征的变化。事实上，IR-MSP检测到形态学变化的前兆。实际测量 IR-MSP中的诊断方法具有客观性和可量化性，因此，该诊断方法比现有方法更敏感、特异、可重复和可靠。 在这项建议中，我们会发展子宫颈细胞涂片的IR-MSP测试方法，包括净化脱落细胞， 细胞，在合适的基底上制备细胞单层，通过配备有焦平面阵列检测器的红外显微光谱仪对约104个单个细胞进行光谱成像，并通过多变量统计方法分析收集的数据以得出诊断。这项工作有可能通过进一步减少假阳性和假阴性诊断，并引入快速和即时常规筛查测试来改善宫颈癌筛查。

DESCRIPTION (provided by applicant): This proposal is aimed at establishing Infrared Microspectroscopy (IR-MSP) as a faster, less expensive, more objective and more accurate technology for the detection of cervical dvsplasia than presently used methods. Screening for cervical disease is presently carried out via a cytological procedure (the Papanicolaou, or "Pap" test), that was first proposed in the late 1940's [Papanicolaou, 1948]. Although regularly scheduled gynecological screening using the Pap test has reduced the incidence of, and mortality from, cervical cancer enormously, there remains a relatively high rate of inaccurate or inconclusive diagnoses [US Department of Health and Human Services, 1989]. Classical cytology is a visual inspection method based on locating and recognizing cells with altered morphology as an indicator of disease. The morphological changes are a consequence of cellular mutations. Although well established, this approach suffers from the fact that the interpretation of morphological change is human-based and therefore, subjective in nature. Furthermore, operator fatigue, training and experience influence the quality, reliability and reproducibility of cytological diagnoses. To alleviate the inherent limitation of visual inspection, computer based inspection by imaging technology has been developed and utilized over the past ten years. However, computer based image analysis has not significantly improved the reliability of the diagnoses, and has not proved cost effective [Hutchinson, 1996]. IR-MSP is a novel technique that recognizes abnormality by detecting cellular composition and variations therein, rather than by changes in morphological features. In fact, IR-MSP detects the precursor of the morphological change. The actual measurement carded out in IR-MSP is objective and quantifiable; consequently, the diagnostic method is more sensitive, specific, reproducible and reliable than existing methods. In this proposal, the methodology for IR-MSP testing of cervical smears will be developed, including the purification of the exfoliated cells, preparation of a cell monolayer on a suitable substrate, spectral imaging of about 104 individual cells via an infrared microspectrometer equipped with a focal plane array detector, and analysis of the collected data via multivariate statistical methods to arrive at a diagnosis. This work has the potential to improve cervical cancer screening by further reducing false positive and false negative diagnoses, and introducing fast and point-of-care routine screening tests.