Infrared Microspectroscopy for Cervical Cancer Screening

描述(申请人提供)：这项建议旨在建立红外显微光谱分析(IR-MSP)作为一种比目前使用的方法更快、更便宜、更客观和更准确地检测宫颈发育不良的技术。目前对宫颈疾病的筛查是通过细胞学方法(巴氏试验或巴氏试验)进行的，这是在20世纪40年代末首次提出的S[帕帕尼科劳，1948年]。尽管定期安排的使用巴氏试验的妇科筛查大大降低了宫颈癌的发病率和死亡率，但不准确或不确定的诊断比率仍然相对较高[美国卫生与公众服务部，]。经典细胞学是一种基于定位和识别形态改变的细胞作为疾病指标的视觉检查方法。形态变化是细胞突变的结果。虽然这种方法已经确立，但由于对形态变化的解释是以人为本的，因此在本质上是主观的，这一点受到了影响。此外，操作员的疲劳、培训和经验影响细胞学诊断的质量、可靠性和重复性。为了缓解视觉检测的固有局限性，在过去的十年里，基于计算机的成像检测技术得到了发展和应用。然而，基于计算机的图像分析并没有显著提高诊断的可靠性，也没有证明具有成本效益(Hutchinson，1996)。IR-MSP是一种新的技术，它通过检测细胞组成及其变化来识别异常，而不是通过形态特征的变化来识别。事实上，IR-MSP检测到了形态变化的前兆。在IR-MSP中进行的实际测量是客观和可量化的，因此，该诊断方法比现有的方法更敏感、特异、重复性和可靠性更高。在这项提案中，将建立宫颈涂片的IR-MSP检测方法，包括提纯脱落细胞，在合适的底物上制备细胞单层，通过配备焦平面阵列探测器的红外显微光谱仪对大约104个单个细胞进行光谱成像，并通过多元统计方法分析收集的数据，以得出诊断结果。这项工作有可能通过进一步减少假阳性和假阴性诊断，并引入快速和护理点常规筛查测试来改进宫颈癌筛查。

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.