Identification of cervical intraepithelial neoplasia (CIN) using UV-excited fluorescence and diffuse-reflectance tissue spectroscopy.
OBJECTIVE
The diagnostic potentials of ultraviolet-excitation fluorescence spectroscopy and diffuse-reflectance spectroscopy of tissue are assessed in a study to identify cervical intraepithelial neoplasia (CIN) in vivo. A multivariate algorithm is used to classify tissue into normal tissues, CIN I, and CIN II/III categories, based on spectral characteristics of biopsied tissue sites.


METHODS
An optical instrument with the capability of measuring fluorescence and diffuse-reflectance spectra from 120 locations uniformly distributed over the surface of the cervix is described. Using this device, these optical spectra of the cervix were measured on women referred for colposcopy due to an abnormal Pap smear.


RESULTS
UV fluorescence differentiates CIN II/III lesions from normal squamous tissue with a sensitivity and specificity of 91 and 93%, respectively. CIN I is distinguished from normal tissue with a sensitivity of 86% and a specificity of 87%.


CONCLUSIONS
Optical spectroscopy shows promise for the detection of pre-cancerous cervical lesions in vivo. The fluorescence and reflectance methods are complementary in their ability to differentiate different tissue types, making the use of the two techniques together more diagnostic than the use of either method separately.
Nordstrom
R J
RJ
MediSpectra, Inc., 45 Hartwell Ave., Lexington, MA 02421, USA. robertn@medispectra.com
Burke
L
L
Niloff
J M
JM
Myrtle
J F
JF
D000465:Algorithms; D005260:Female; D006801:Humans; D055095:Optics and Photonics / Q000295:instrumentation; D065006:Papanicolaou Test; D013050:Spectrometry, Fluorescence; D013057:Spectrum Analysis / Q000379:methods; D014466:Ultraviolet Rays; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*