Fluorescence Spectroscopy to Detect Oral Neoplasia

描述(申请人提供)：这项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早期检测和诊断口腔肿瘤的新方法。口腔癌是一个主要的全球健康问题。早期发现和诊断是提高生存率和降低口腔癌发病率的最好方法；但目前还没有实现这一目标的方法。荧光和反射光谱可以非侵入性地探测组织在癌变过程中发生的生化和结构变化，数学模型可以将这些变化中的一些变化，如代谢活动增加和血管生成，联系起来观察光谱。在过去的四年中，我们已经证明，荧光和反射光谱可以非侵入性、客观地区分正常和异常的口腔粘膜，具有良好的敏感性和特异性-类似于口腔癌症专家的做法。这项建议的目标是利用这些进展来开发、评估和优化一种在社区环境中使用荧光和反射光谱的口腔癌症筛查方法，以促进口腔病变的检测和诊断。作为这次竞争更新的一部分，我们现在准备整合从这些研究中获得的知识，以实现四个重要目标：(1)将这些研究结果转化为开发一种简化的、非侵入性的和客观的设备，供社区使用；(2)实施实时数据分析软件，在护理点提供具有临床意义的诊断；(3)测试该设备在各种临床环境中检测口腔异型增生和早期癌症的性能，并优化其与现有诊断方法的集成；以及(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，这种新的生物标志物可以在体内测量，而不需要活组织检查。这项研究计划的成功完成将为口腔肿瘤的筛查提供一种便携式的客观设备，可以在口腔癌症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。通过这项建议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中的口腔癌筛查和监测。此外，结果将显示可检测的光学特征是否可以作为生物标记物，更好地识别哪些患者进展为浸润性癌症的风险较高。这种方法的使用，如果成功，可以显著改善世界各地可能患有口腔恶性肿瘤的人的存活率和生活质量 公共卫生相关性：口腔癌是世界范围内的一个主要健康问题。为了改善结果，我们必须改进对早期肿瘤性改变的检测和诊断。需要一种简单、自动化的方法，使社区医护人员能够筛查可疑口腔病变的高危个体，并确定可疑口腔病变个体的恶变风险。我们的目标是开发一种基于光谱和成像的口腔检测和诊断方法。在过去的四年中，我们已经证明，荧光和反射光谱可以非侵入性、客观地区分正常和异常的口腔粘膜，具有良好的敏感性和特异性-类似于口腔癌症专家的做法。我们对口腔肿瘤性病变反射和荧光差异的生物学基础的了解有所改善，这表明我们可以使用深度选择性来提高诊断性能。作为这次竞争更新的一部分，我们现在准备整合从这些研究中获得的知识，以实现四个重要目标：(1)将这些研究结果转化为开发一种简化的、非侵入性的和客观的设备，供社区使用；(2)实施实时数据分析软件，在护理点提供具有临床意义的诊断；(3)测试该设备在各种临床环境中检测口腔异型增生和早期癌症的性能，并优化其与现有诊断方法的集成；以及(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，这种新的生物标志物可以在体内测量，而不需要活组织检查。这项研究计划的成功完成将为口腔肿瘤的筛查提供一种便携式的客观设备，可以在口腔癌症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。此外，通过这项建议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中的口腔癌筛查和监测。这种方法的使用可以显著改善世界各地可能患有口腔恶性肿瘤的人的生存和生活质量。。

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. .