自体荧光光谱检测胃浆膜识别胃癌组织

Identification of Gastric Cancer by Autofluorescence Spectrum in Gastric Serosa

目的探讨自体荧光光谱从胃浆膜识别胃癌的可行性,为手术中准确确定胃癌切除范围奠定基础。方法选用激光源Xe灯的308、337、365和405nm14种激发波长测试和比较了41例患者胃癌、癌旁、正常处胃浆膜的自体荧光光谱。结果405nm激发正常组、癌旁组、胃癌组的单主峰强度依次减弱(P<0.05),可依此区分3组标本。胃癌组在610-630nm存在卟啉特征峰,胃癌组明显高于正常组(P<0.01);365nm激发可识别胃癌与正常组,但不能区分癌旁组(P>O.05);337YIITI、308niql激发从正常组到胃癌组双主峰强度逐步成相反的变化趋势,双峰强度比可有效区分3组标本,但308nm激发(P<0.01)比337nm激发(P<0.05)的可区分度更高。结论4种波长激发均能区分正常胃浆膜与胃癌浆膜,其中308nm、337nm、405nm激发的荧光光谱能更灵敏地区分胃癌、癌旁及正常胃浆膜,308nm的效果最好。

Objective To study the feasibility for identifying gastric cancer in normal gastric serosa in vitro, and to lay foundation for developing a method in accurately determining tumor margin in radical resection of gastric cancer during operation. Methods The autofluorescence spectrum of gastric serosa in gastric cancer, paracancerous tissue, and normal tissue from41 cases of patients was analysised in vitro using 4 kinds of excitation wavelength respectively. Results The intensity of the single major peak excitated by 405 nm decreased in turn in three groups (P < 0. 05 ). There was a specific peak of prophyrin within 610-630 nm, and the peak of gastric cancer group was higher than that of normal group (P < 0. 01) . The spectrum excitated by 365 nm could identify gastric cancer from normal serosa, but it could not identify the paracancerous tissue from normal serosa (P >0. 05). The double major peak excitated by 337 nm, and 308 nm in gastric cancer is counterturn contrasting in nor- mal serosa. The ratio of two peaks could distinguish gastric cancer from normal serosa effectively. The ratio of 308 nm excitation wavelength was more effective. Conclusions Gastric cancer could be identified from normal gastric serosa in vitro by autofluorescence in all 4 excitation wavelengths. 308 nm,337 nm,405 nm excitation wavelength are more effective. The gastric cancer, paracancerous tissue, and normal tissue from gastric serosa could be identified by the above 3 excitation wavelengths. The most effective excitation wavelength was 308 nm.