IN-VIVO CANCER-DIAGNOSIS OF THE ESOPHAGUS USING DIFFERENTIAL NORMALIZED FLUORESCENCE (DNF) INDEXES

Background and Objective: We report the use of new diagnostic paramete rs based on the differential normalized fluorescence (DNF) signals for malignant tumor diagnosis. Study Design/Materials and Methods: Over 2 00 measurements of endogenous fluorescence from normal and malignant e sophageal tissues were performed during routine endoscopy in 48 patien ts. A pulsed nitrogen-pumped dye laser was used to provide in situ exc itation at 410 nm. Direct collection of the fluorescence signal emitte d by the tissue was achieved using an intensified photodiode array det ector equipped with a fiberoptic probe. Results: The fluorescence sign als were normalized with respect to the total fluorescence signal area . The cancer diagnosed indices were defined by the difference between the normalized fluorescence signal of a tumor and the mean value of a reference set of normal tissues. The results of the DNF approach were compared with endoscopic examinations and histopathology interpretatio ns of the biopsy samples. Excellent correlation in the classification of normal and malignant tumors for the samples was found. Conclusion: The data indicated that the DNF approach has a significant potential t o provide a direct, real-time, and in-situ technique for cancer diagno sis of the esophagus without requiring biopsy of the tumors and time-c onsuming histopathology tests. (C) 1995 Wiley-Liss, Inc.