Multispectral Imaging for Oral Cancer Detection

描述(申请人提供)：口腔癌是一个主要的健康问题。总体而言，所有口腔癌患者的五年生存率仅略高于50%；对于晚期患者，30年来生存率一直保持在30%-40%或更低。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，大多数患者仍然患有晚期肿瘤。早期检测改善了口腔癌患者的预后，但临床早期检测工具的敏感度和特异度有限。因此，需要确定有效的筛查和癌症早期诊断手段，以改进早期发现工作。这项提议的目标是开发一种新的技术，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，可以提供组织的高分辨率彩色图像。它可以在两种模式下工作：(1)它可以成像从组织反射的光的颜色，(2)它可以用来成像组织在单色光照射下产生的自发荧光。我们的研究小组已经证明，癌变过程会导致上皮细胞和支持间质的光学性质发生变化。我们之前的工作仅限于对活检大小的小区域组织进行采样，可以用铅笔大小的光纤探头进行评估。在这项提议中，我们将检验这一假设，即在癌变过程中产生的生物化学和组织形态的变化可以使用多光谱数字显微镜实时成像。在目标1中，我们将比较MDM成像和标准白光检查在小型临床研究中评估口腔病变的能力。在目标2中，我们将评估MDM成像与标准白光检查相比描绘口腔癌和异型增生外周粘膜边缘的能力。在这两个试验中，标准的组织病理学评估将被用作金标准。在目标3中，我们将根据我们使用MDM成像的结果开发初步的诊断算法，并确定这些算法在非侵袭性区分非典型增生和早期癌与良性病变和正常黏膜方面的敏感性和特异性。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成像作为改进口腔肿瘤检测和监测的临床工具的可行性。

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.