Novel Optical Probe for Oral and Dental Tissue Screening

描述(申请人提供)：我们将继续开发一种新的光学探头，用于非侵入性表征和监测导致异型增生并最终导致浸润性鳞癌的口腔上皮的生化和形态变化。口腔鳞状细胞癌是一种病理疾病，大约一半的患者在确诊后五年内死亡，并可能给幸存的患者留下严重的美学和/或功能损害。口腔癌前病变的早期发现可以对口腔癌死亡率产生巨大影响，将生存率从50%提高到80%左右。目前口腔癌筛查的方法包括通过应用醋酸溶液或甲苯胺蓝或卢戈尔碘等染色来增强目测评估。最终的评估是通过侵入性切除活检。视觉评估在临床医生之间的感知上存在很大的差异，并且无法发现肿瘤转化的极早期迹象。活检只能有节制地使用。在这项建议中，我们将结合组织自发荧光成像的力量(对与早期肿瘤转化相关的生化变化高度敏感)和光学相干断层扫描(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，我们生产了一种可以用于快速和明确的口腔病理筛查或诊断的仪器。我们将在UTMB耳鼻喉科诊所对80名患者的研究中描述该仪器的用途。最后，虽然我们将这一应用重点放在口腔癌上，但FIG-OCT系统也将在许多其他组织中广泛应用，包括宫颈、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.