Fluorescence Spectroscopy to Detect Oral Neoplasia

描述（由申请人提供）：本提案的目标是开发一种基于荧光和反射光谱和成像的无创口腔肿瘤早期检测和诊断的新方法。口腔癌是一个重大的全球健康问题。早期发现和诊断是提高口腔癌生存率和降低发病率的最佳途径；然而，目前还没有办法实现这一目标。荧光和反射光谱学可以无创地探测癌变过程中发生的组织生化和结构变化，数学模型可以将这些变化联系起来，例如代谢活性和血管生成的增加，以观察光谱。在过去的四年里，我们已经证明荧光和反射光谱可以无创和客观地区分正常和异常的口腔粘膜，具有良好的灵敏度和特异性-类似于口腔癌专家。本提案的目标是利用这些进展来开发，评估和优化在社区环境中使用荧光和反射光谱的口腔癌筛查方法，以促进口腔病变的检测和诊断。作为竞争更新的一部分，我们现在准备整合这些研究中获得的知识，以实现四个重要目标：(1)将这些研究成果转化为一种简化，非侵入性和客观的设备，以供社区使用；(2)实施实时数据分析软件，在护理点提供有临床意义的诊断；(3)测试该设备在各种临床环境下检测口腔发育不良和早期癌的性能，并优化其与现有诊断方法的整合；(4)研究光谱学作为一种新的恶性转化风险生物标志物的能力，该标志物无需活体活检即可在体内测量。该研究项目的成功完成将为口腔肿瘤的筛查提供一种便携式客观设备，可在口腔癌专业知识有限且最迫切需要筛查的初级保健牙科和医疗环境中实施。通过该提案获得的知识将促进新诊断技术的最佳整合，以优化不同患者群体的口腔癌筛查和监测。此外，研究结果将显示可检测的光学特征是否可以作为生物标志物，更好地识别哪些患者有发展为浸润性癌症的高风险。这种方法的使用，如果成功，可以显著提高世界范围内可能患有口腔恶性肿瘤的人的生存率和生活质量

DESCRIPTION (provided by applicant): The goal of this proposal is to develop a promising new approach for non-invasive early detection and diagnosis of oral neoplasia based on fluorescence and reflectance spectroscopy and imaging. Oral cancer is a major global health problem. Early detection and diagnosis is the best way to improve survival and reduce morbidity from oral cancer; yet no method currently exists to accomplish this goal. Fluorescence and reflectance spectroscopy can non-invasively probe biochemical and architectural changes in tissue that occur during carcinogenesis, and mathematical models can relate some of these changes, such as increased metabolic activity and angiogenesis, to observe optical spectra. Over the last four years, we have shown that fluorescence and reflectance spectroscopy can non-invasively and objectively discriminate between normal and abnormal oral mucosa with good sensitivity and specificity - similar to that of oral cancer specialists. The goal of this proposal is to leverage these advances to develop, evaluate and optimize an oral cancer screening approach using fluorescence and reflectance spectroscopy in a community setting to facilitate detection and diagnosis of oral lesions. As part of this competitive renewal, we are now poised to integrate the knowledge gained in these studies to achieve four important goals: (1) to translate these research findings to develop a simplified, non-invasive and objective device to be used in the community; (2) to implement real time data analysis software to provide a clinically meaningful diagnosis at the point-of-care; (3) to test the performance of this device to detect oral dysplasia and early carcinoma in various clinical settings and optimize its integration with existing diagnostic methods; and (4) to investigate the ability of optical spectroscopy as a new biomarker of risk of malignant conversion that can be measured in vivo without the need for biopsy. Successful completion of this research program will provide a portable objective device to screen for oral neoplasia that can be implemented in primary care dental and medical environments where oral cancer expertise is limited and screening is most urgently needed. Knowledge gained through this proposal will facilitate optimal integration of new diagnostic technologies to optimize oral cancer screening and surveillance in diverse patient populations. Further, results will show whether detectable optical features can serve as biomarkers to better identify which patients are at high risk to progress to invasive cancer. The use of this approach, if successful, could significantly improve the survival and quality of life of people worldwide who are likely to suffer from oral malignancies PUBLIC HEALTH RELEVANCE: Oral cancer is a major health problem worldwide. To improve outcomes we must improve detection and diagnosis of early neoplastic changes. A simple, automated method to enable community healthcare workers to screen high risk individuals for suspicious oral lesions and a way to determine risk of malignant conversion in individuals with suspicious oral lesions is required. Our goal is to develop such an approach to oral detection and diagnosis based on optical spectroscopy and imaging. Over the last four years, we have shown that fluorescence and reflectance spectroscopy can non-invasively and objectively discriminate between normal and abnormal oral mucosa with good sensitivity and specificity - similar to that of oral cancer specialists. Our improved understanding of the biological basis for differences in reflectance and fluorescence of neoplastic oral lesions suggests that we can use depth-selectivity to enhance diagnostic performance. As part of this competitive renewal, we are now poised to integrate the knowledge gained in these studies to achieve four important goals: (1) to translate these research findings to develop a simplified, non-invasive and objective device to be used in the community; (2) to implement real time data analysis software to provide a clinically meaningful diagnosis at the point-of-care; (3) to test the performance of this device to detect oral dysplasia and early carcinoma in various clinical settings and optimize its integration with existing diagnostic methods; and (4) to investigate the ability of optical spectroscopy as a new biomarker of risk of malignant conversion that can be measured in vivo without the need for biopsy. Successful completion of this research program will provide a portable objective device to screen for oral neoplasia that can be implemented in primary care dental and medical environments where oral cancer expertise is limited and screening is most urgently needed. Further, knowledge gained through this proposal will facilitate optimal integration of new diagnostic technologies to optimize oral cancer screening and surveillance in diverse patient populations. The use of this approach could significantly improve the survival and quality of life of people worldwide who are likely to suffer from oral malignancies. .