Age and FSH effects in fluorescence spectra from the cervix: an exploratory analysis

Real-time optical technologies that could diagnose cervical cancer could improve the detection of cervical cancer. Our group is studying the technology assessment of optical devices in the screening and diagnosis of cervical neoplasias.

We have conducted a diagnostic trial in 850 patients with referral Papanicolaou smears showing ASCUS or greater. Each colposcopically abnormal site and two normal sites were measured with fluorescence and reflectance spectroscopy and then biopsied. Each site generates a fluorescence excitation emission matrix that has a 3-dimensional map with peaks and valleys.

The early exploration of these data is presented and shows an effect of age, Follicle Stimulating Hormone or FSH, and, curiously, of their interaction. We have examined other biographical variables like smoking, HPV positivity, grade of CIN, device used, probe used, race, ethnicity, gravidity, parity, previous treatments, and others. None are significant predictors of this finding of increased intensity, except age and FSH.

The effect of age supports the work done on fresh tissue slices in trying to better understand the biology of fluorescence. The effect of FSH is not a surrogate for age, but an independently significant effect, for which we currently do not have an explanation. We are exploring if FSH is a surrogate for estrogenization by measuring estradiol levels and calculating the BMI.