NONINVASIVE DIAGNOSIS OF ORAL NEOPLASIA BASED ON FLUORESCENCE SPECTROSCOPY AND NATIVE TISSUE AUTOFLUORESCENCE

Objective: To evaluate the clinical potential of fluorescence spectros copy (a noninvasive technique for assessing the chemical and morpholog ic composition of tissue) for in vivo detection of oral cavity neoplas ia. Design: A fluorescence spectroscopy system recorded spectra from o ral cavity sites in 8 healthy volunteers and in 15 patients with prema lignant or malignant oral cavity lesions at 337-, 365-, and 410-nm exc itation wavelengths in the emission range of 350 to 700 nm. Fluorescen ce peak intensities and spectral line shapes were compared and diagnos tic algorithms were developed to distinguish normal sites from abnorma l sites. Setting: The head and neck cancer clinic at a tertiary referr al center in Houston, Tex. Results: Differences were found in spectra from normal, dysplastic, and malignant oral mucosa. The fluorescence i ntensity of normal mucosa was greater than that of abnormal areas; In addition, the ratio of red region (635-nm) to blue region (455-490-nm) intensities was greater in abnormal areas. Diagnostic discrimination was achieved when test site spectra were compared with spectra from a normal site in the same patient. One diagnostic algorithm based on spe ctra at 337 nm gave a sensitivity of 88% and a specificity of 100%. Co nclusions: Consistent differences exist between the fluorescence spect ra of abnormal and normal oral mucosa. Therefore, fluorescence spectro scopy has the potential to improve the noninvasive diagnosis of oral c avity neoplasia. Further studies will better define the role of this t echnique in the detection of premalignant and early oral cancer lesion s.