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Published on: May 11, 2014
Autofluorescence spectroscopy for the diagnosis of cervical intraepithelial neoplasia
Helmut Weingandt1, Herbert Stepp, Reinhold Baumgartner
1Department of Obstetrics and Gynaecology, University Munich-Grosshadern, 81377 Munich, Germany.
Objective:
To assess the feasibility of autofluorescence spectroscopy in the diagnosis of cervical intraepithelial neoplasia (CIN) using broadband light excitation.
Design:
Feasibility study.
Setting:
Colposcopy clinic of an university hospital.
Population:
Sixty-eight patients at risk for CIN.
Methods:
After excitation with a broadband light between 375 and 440 nm, spectral distribution of native tissue fluorescence (autofluorescence) was acquired from 685 cervical sites for the localisation and differentiation of CIN, and compared with colposcopically directed biopsy and human papillomavirus (HPV) DNA testing.
Main Outcome Measure:
Detection of CIN.
Results:
The evaluation of spectral measurements revealed significantly lower autofluorescence values for CIN 3 lesions compared with normal tissue (P < 0.001), and compared with CIN 1 or CIN 2 (P < 0.002). High grade CIN lesions (CIN 2/3) presented with a significant reduced autofluorescence compared with CIN 1 (P < 0.002). Patients with a positive HPV DNA testing showed a significantly lower autofluorescence than patients tested negative for HPV DNA (P < 0.05). Severe inflammation such as chronic cervicitis may lead to false positive results.
Conclusions:
Autofluorescence spectroscopy represents an interesting approach for the detection of cervical neoplasia. Using an excitation wavelength band between 375 and 440 nm, significant differences between normal and precancerous lesions of the cervix can be seen.
