Novel Optical Probe for Oral and Dental Tissue Screening

描述（由申请人提供）：我们将继续开发一种新型光学探针，用于非侵入性表征和监测口腔上皮中导致发育异常并最终导致浸润性鳞状细胞癌的生化和形态学变化。口腔鳞状细胞癌是一种病理状况，在诊断后五年内约有一半的患者死亡，并可能使幸存的患者具有严重的美学和/或功能损害。口腔癌前病变的早期检测可以对口腔癌死亡率产生巨大影响，将生存率从50%提高到约80%。目前的口腔癌筛查方法包括通过应用乙酸溶液或染色剂如甲苯胺蓝或卢戈碘增强的视觉评估。通过侵入性切除活检进行连续性评估。视觉评估在临床医生之间的感知存在很大的差异，并且无法检测到肿瘤转化的极早期迹象。活检只能少量使用。在这个建议中，我们将联合收割机的力量组织自体荧光成像，（这是高度敏感的生化变化与非常早期的肿瘤转化）与光学相干断层扫描（提供详细的亚表面形态信息。）通过结合这两种模式，我们可以利用荧光成像的速度和灵敏度来指导OCT成像的高度特异性应用。通过这种方式，我们生产了一种可用于快速和明确的口腔病理学筛查或诊断的仪器。我们将在UTMB耳鼻喉科诊所的80例患者的研究中描述该仪器的实用性。最后，虽然我们将此应用集中在口腔癌上，但FIG-OCT系统也将广泛应用于许多其他组织，包括子宫颈、膀胱、结肠和上消化道。

DESCRIPTION (provided by applicant): We will continue development of a novel optical probe for non-invasive characterization and monitoring of the biochemical and morphological changes in oral cavity epithelium leading to dysplasia and ultimately to invasive squamous cell carcinoma. Oral squamous cell carcinoma is a pathological condition that kills approximately half of patients afflicted within five years of diagnosis and may leave surviving patients with severe aesthetic and/or functional compromises. Early detection of oral precancerous lesions can have a dramatic impact on oral cancer mortality rates, increasing survival rates from 50% to about 80%. Current methods of oral cancer screening include visual assessment enhanced by application of acetic acid solution or stains such as toluidine blue or Lugol iodine. Definitive assessment is by invasive excisional biopsy. Visual assessment suffers from a wide variability in perception between clinicians and is unable to detect extremely early signs of neoplastic transformation. Biopsy can only be used sparingly. In this proposal we will combine the power of tissue autofluorescence imaging, (which is highly sensitive to biochemical changes associated with very early neoplastic transformation) with optical coherence tomography (which provides detailed sub-surface morphological information.) By combining these two modalities, we can leverage the speed and sensitivity of fluorescence imaging to direct the highly specific application of OCT imaging. In this way we produce an instrument which can be used for rapid and definitive screening or diagnosis of oral pathology. We will characterize the utility of the instrument in a study of 80 patients in the UTMB ENT clinic. Finally, while we have focused this application on oral cancer, the FIG-OCT system will have wide application in a number of other tissues as well including cervix, bladder, colon, and upper GI tract.