Oral Screening in India using Optical Imaging Technology

口腔癌是全球第六大常见癌症，超过三分之二的病例发生在发展中国家。在印度，它是男性中最常见的癌症，在女性中排名第三。只有一半的口腔癌患者能活5年，晚期患者存活的更少。早期发现和诊断的进步将大大提高口腔癌的生存率，减少口腔癌患者的痛苦。光学辅助诊断是一种很有前途的新技术，可以改善上皮恶性肿瘤的检测。在癌变过程中，组织的光学特性发生改变，这些变化可用于无创区分正常和肿瘤粘膜。该国际合作项目建立在先前NIH资助的工作的基础上，目的是确定新的光学成像技术，荧光和反射成像和光谱学，是否可以促进印度高危人群口腔肿瘤的早期发现和诊断。我们的第一个目的是确定多光谱成像和光谱学是否可以改善印度高危人群中潜在恶性口腔病变的筛查和诊断。我们将在印度孟买塔塔纪念医院招募90名患者进行口腔癌筛查试验，获得口腔癌前病变（opl）的广域自身荧光和反射图像。这些图像将与使用标准白光（WL）照明的结果进行比较。同时，将使用荧光和反射光谱从几个地点进行深入的焦点探测。将比较使用标准白光的临床诊断、使用多光谱成像的临床诊断、光谱数据以及细胞学和组织病理学诊断，以确定使用该设备的阳性和阴性预测值。在目的2中，我们将确定该技术是否可以改善印度口腔癌高风险人群的筛查和诊断，但使用类似的方法没有临床可见的病变。在Aim 3中，我们评估了遗传损伤（如非整倍体和杂合性缺失）和形态变化（角化过度、炎症、发育不良）与光学特征改变的相关性。该项目的成功完成将决定该技术在资源有限的社区中用于口腔癌检测和诊断的诊断潜力和适用性。7. 口腔癌是全球第六大常见癌症，超过三分之二的病例发生在发展中国家。在印度，它是男性中最常见的癌症，在女性中排名第三。只有一半的口腔癌患者能活5年，晚期患者存活的更少。早期发现和诊断的进步将大大提高口腔癌的生存率，减少口腔癌患者的痛苦。光学辅助诊断是一种很有前途的新技术，可以改善上皮恶性肿瘤的检测。该国际合作项目建立在先前NIH资助的工作的基础上，目的是确定新的光学成像技术，荧光和反射成像和光谱学，是否可以促进印度高危人群口腔肿瘤的早期发现和诊断。我们将确定多光谱成像和光谱学是否可以改善印度高危人群中潜在恶性口腔病变的筛查和诊断。我们将在印度孟买塔塔纪念医院招募190名受试者进行口腔癌筛查试验，将其光学数据与标准临床诊断、组织病理学结果和分子生物标志物结果进行比较。该项目的成功完成将决定该多光谱成像和光谱技术在资源有限的社区中用于口腔癌检测和诊断的诊断潜力和适用性。

DESCRIPTION (provided by applicant): Oral cancer is the sixth most common cancer worldwide and over two thirds of cases occur in developing countries. In India, it is the most common cancer in men and the third most common in women. Only half of oral cancer patients live 5 years, even less of those with advanced stage disease survive. Advances in early detection and diagnosis would greatly improve survival and decrease suffering from oral cancer. Optical based diagnostic aids are promising new technologies to improve detection of epithelial malignancies. During carcinogenesis, the optical properties of tissue are altered and these changes can be used to non-invasively distinguish normal from neoplastic mucosa. The objective of this international collaborative project, which builds upon previous NIH funded work, is to determine whether new optical imaging technology, fluorescence and reflectance imaging and spectroscopy, can facilitate early detection and diagnosis of oral neoplasia in a high risk population in India. Our first Aim is to determine whether multispectral imaging and spectroscopy can improve screening and diagnosis of potentially malignant oral lesions in a high risk population in India. We will obtain wide-field autofluorescence and reflectance images of oral premalignant lesions (OPLs) in 90 patients who are recruited for oral cancer screening trials at the Tata Memorial Hospital in Mumbai India. These images will be compared to findings using standard white light (WL) illumination. At the same time, an in depth, focal interrogation from several sites using fluorescence and reflectance spectra will be performed. Clinical diagnoses using standard white light, clinical diagnoses using multispectral imaging, spectroscopy data, and cytology and histopathology diagnoses will be compared to determine the positive and negative predictive value of using the device. In Aim 2, we will determine whether this technology can improve screening and diagnosis in an Indian population with high risk for oral cancer but no clinically visible lesions using similar methodology. In Aim 3, we evaluate the correlation of presence of genetic damage (such as aneuploidy and loss of heterozygosity) and morphologic changes (hyperkeratosis, inflammation, dysplasia) to altered optical signatures. Successful completion of this project will determine the diagnostic potential and applicability of this technology for oral cancer detection and diagnosis in communities with limited resources. 7. Project Narrative Oral cancer is the sixth most common cancer worldwide and over two thirds of cases occur in developing countries. In India, it is the most common cancer in men and the third most common in women. Only half of oral cancer patients live 5 years, even less of those with advanced stage disease survive. Advances in early detection and diagnosis would greatly improve survival and decrease suffering from oral cancer. Optical based diagnostic aids are promising new technologies to improve detection of epithelial malignancies. The objective of this international collaborative project, which builds upon previous NIH funded work, is to determine whether new optical imaging technology, fluorescence and reflectance imaging and spectroscopy, can facilitate early detection and diagnosis of oral neoplasia in a high risk population in India. We will determine whether multispectral imaging and spectroscopy can improve screening and diagnosis of potentially malignant oral lesions in a high risk population in India. We will compare optical data in 190 subjects who are recruited for oral cancer screening trials at the Tata Memorial Hospital in Mumbai India, to standard clinical diagnosis, histopathologic results, and molecular biomarker findings. Successful completion of this project will determine the diagnostic potential and applicability of this multispectral imaging and spectrsocpy technology for oral cancer detection and diagnosis in communities with limited resources.