Light-induced autofluorescence spectroscopy for the endoscopic detection of esophageal cancer

Background: Any innovative optical system that facilitates the early endosc opic detection of neoplastic change in the GI mucosa has the potential to g reatly improve survival and quality of life for patients prone to have GI m alignancies develop. The present article describes light-induced autofluore scence 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 obtai ned from normal mucosa and malignant lesions in 9 patients with squamous ce ll cancer and 4 with adenocarcinoma of the esophagus. Following spectrograp hic measurements, biopsy specimens were obtained for definitive classificat ion of the spectra. A special light source capable of delivering either whi te or violet-blue light for excitation of tissue autofluorescence by means of an endoscope was used. Endogenous fluorescence spectra emitted by tissue s were detected with a fiberoptic probe and analyzed with a spectrograph. Results: Squamous cell cancer and adenocarcinoma of the esophagus exhibit s pecific changes in the emitted fluorescence spectra as compared with normal mucosa. Based on the results obtained in earlier studies, malignant and be nign spectra were differentiated with the aid of a mathematical algorithm. By using this algorithm, a sensitivity of 97% and specificity of 95% were o btained for the diagnosis of esophageal carcinoma. Conclusions: Light-induced fluorescence spectroscopy is useful for the endo scopic detection of squamous cell cancer and adenocarcinoma of the esophagu s. This spectroscopic study provides a basis for the design of a simplified autofluorescence imaging system for detection of esophageal neoplasms.