Multispectral Imaging for Oral Cancer Detection

描述（由申请人提供）：口腔癌是一个主要的健康问题。所有口腔癌患者的总体五年生存率仅略高于50%;对于晚期疾病患者，生存率在30-40%或更低，持续30年。早期疾病的患者有更好的治愈机会和良好的功能结果，但即使在这个国家，大多数患者仍然存在晚期肿瘤。早期检测可以改善口腔癌患者的预后，但早期检测的临床工具的灵敏度和特异性有限。因此，需要确定筛查和早期癌症诊断的有效手段，以改善早期检测工作。该提案的目标是开发一种新技术，多光谱数字显微镜（MDM）成像，用于口腔肿瘤的非侵入性检测。MDM是一种新型的数字显微镜，可提供高分辨率的组织彩色图像。它可以在两种模式下操作：（1）它可以对从组织反射的光的颜色进行成像，以及（2）它可以用于对当用单色光照射时由组织产生的自体荧光进行成像。我们的研究小组已经表明，癌变过程中产生的上皮细胞和支持基质的光学特性的变化。我们以前的工作仅限于对活检大小的小组织区域进行采样，可以用一个活检大小的光纤探头进行评估。在这项建议中，我们将测试的假设，即在癌变过程中产生的生物化学和组织形态学的变化可以在真实的时间成像使用多光谱数字显微镜。在目标1中，我们将在一项小型临床研究中比较MDM成像与标准白色光检查评估口腔病变的能力。在目标2中，我们将评估MDM成像与标准白色光检查相比在描绘口腔癌和异型增生的外周粘膜边缘方面的能力。在这两项试验中，标准组织病理学评价将用作金标准。在目标3中，我们将根据我们使用MDM成像的结果开发初步诊断算法，并确定这些算法的灵敏度和特异性，以非侵入性地区分异型增生和早期癌与良性病变和正常粘膜。此外，我们将确定在未来大规模临床试验中测试的最佳波长组合。这项研究的成功完成将确定MDM成像作为临床工具的可行性，以提高口腔肿瘤的检测和监测。

DESCRIPTION (provided by applicant): Oral cancer is a major health problem. Overall five-year-survival rates for all oral cancer patients are barely over 50%; for patients with advanced stage disease survival rates have remained at 30-40% or less for thirty years. Patients with early disease have better chances for cure and good functional outcome, but even in this country, most patients still present with advanced tumors. Early detection improves outcomes for oral cancer patients, yet clinical tools for early detection have limited sensitivity and specificity. Thus, identification of effective means of screening and early cancer diagnosis is needed to improve early detection efforts. The goal of this proposal is to develop a new technology, multispectral digital microscopic (MDM) imaging, for non-invasive detection of oral neoplasia. The MDM is a new type of digital microscope, which provides high-resolution color images of tissue. It can operate in two modes: (1) it can image the color of light reflected from tissue, and (2) it can be used to image the autofluorescence produced by tissue when illuminated with monochromatic light. Our group has shown that the process of carcinogenesis produces changes in the optical properties of epithelial cells and the supporting stroma. Our previous work has been limited to sampling small, biopsy-sized areas of tissue, which can be assessed with a pencil-sized fiber optic probe. In this proposal, we will test the hypothesis that changes in biochemistry and tissue morphology produced during carcinogenesis can be imaged in real time using multi-spectral digital microscopy. In Aim 1 we will compare the ability of MDM imaging to that of standard white light examination for assessment of oral lesions in a small clinical investigation. In Aim 2, we will assess the ability of MDM imaging compared to standard white light examination to delineate peripheral mucosal margins of oral carcinoma and dysplasia. In both trials, standard histopathologic evaluation will be used as the gold standard. In Aim 3, we will develop preliminary diagnostic algorithms based on our results using MDM imaging, and determine the sensitivity and specificity of these algorithms to non-invasively distinguish dysplasia and early carcinoma from benign lesions and normal mucosa. In addition, we will determine the optimal wavelength combinations to be tested in future large-scale clinical trials. Successful completion of this research will determine the feasibility for MDM imaging as a clinical tool to improve detection and monitoring of oral neoplasia.