Light-induced autofluorescence spectroscopy for the endoscopic detection of esophageal cancer.
BACKGROUND
Any innovative optical system that facilitates the early endoscopic detection of neoplastic change in the GI mucosa has the potential to greatly improve survival and quality of life for patients prone to have GI malignancies develop. The present article describes light-induced autofluorescence spectroscopy with violet-blue excitation light for in vivo diagnosis of cancerous tissue of the esophagus during routine endoscopy.


METHODS
One hundred twenty-nine endogenous fluorescence spectra were obtained from normal mucosa and malignant lesions in 9 patients with squamous cell cancer and 4 with adenocarcinoma of the esophagus. Following spectrographic measurements, biopsy specimens were obtained for definitive classification of the spectra. A special light source capable of delivering either white or violet-blue light for excitation of tissue autofluorescence by means of an endoscope was used. Endogenous fluorescence spectra emitted by tissues were detected with a fiberoptic probe and analyzed with a spectrograph.


RESULTS
Squamous cell cancer and adenocarcinoma of the esophagus exhibit specific changes in the emitted fluorescence spectra as compared with normal mucosa. Based on the results obtained in earlier studies, malignant and benign spectra were differentiated with the aid of a mathematical algorithm. By using this algorithm, a sensitivity of 97% and specificity of 95% were obtained for the diagnosis of esophageal carcinoma.


CONCLUSIONS
Light-induced fluorescence spectroscopy is useful for the endoscopic detection of squamous cell cancer and adenocarcinoma of the esophagus. This spectroscopic study provides a basis for the design of a simplified autofluorescence imaging system for detection of esophageal neoplasms.
Mayinger
B
B
Medizinische Klinik I mit Poliklinik der FAU Erlangen-Nuremberg, Erlangen, Germany.
Horner
P
P
Jordan
M
M
Gerlach
C
C
Horbach
T
T
Hohenberger
W
W
Hahn
E G
EG
D000230:Adenocarcinoma / Q000175:diagnosis*; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis*; D016145:Endoscopy, Digestive System / Q000379:methods*; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane; D012680:Sensitivity and Specificity; D013050:Spectrometry, Fluorescence / Q000379:methods*