近红外线激光拉曼光谱具有在分子水平诊断胃癌的价值

Near-infrared Raman spectroscopy for diagnosis of gastric cancer

目的采用近红外线激光拉曼光谱技术研究胃癌组织、胃癌前病变组织及正常胃粘膜组织的拉曼光谱的差异变化,建立一种胃癌光学诊断的方法。方法收集病理学证实的33例胃癌组织、27例胃癌前病变组织及45例正常胃粘膜组织,用近红外线激光拉曼光谱仪进行检测胃病变组织拉曼峰强度比值,所有标本来自105例受试者均为接受胃切除或是接受胃镜下对胃部可疑病灶进行活检的患者。结果﹣典型的拉曼谱峰位于853 cm-1,936 cm-1,1003 cm-1,1032 cm-1,1174 cm-1,1208 cm-1,1323 cm-1,1335 cm-1,1450 cm-1,1655 cm-1谱带处,胃癌组、胃癌前病变组及正常组的激光拉曼光谱分布存在差异(P<0.05,单向方差分析,95%可信区间);﹣拉曼峰强度比值比较:I1003/I1337,I1003/I1450,I1003/I1655,I1156/I1655,健康对照组显著高于胃癌组及胃癌前病变组,三者两两比较差异有统计学意义(P<0.05,单向方差分析,95%可信区间);﹣采用PCA-LDA诊断算法得到正常胃组织、胃癌前病变组织及胃癌组织的灵敏度分别是:81.5%,85.3%,100%,特异度分别是:86%,100%,97.4%。结论近红外线激光拉曼光谱分析技术联合拉曼峰强度比值具有在分子水平诊断胃癌的价值。

Objective To establish a method for early diagnosis of gastric cancer using near-infrared Raman spectroscopy. Methods A rapid near-infrared Raman system was used to examine the tissue specimens of pathologically confirmed gastric cancer （33 cases）, gastric precancerous lesions （27 cases）, and normal gastric mucosa （45 cases）. All the specimens were obtained from 105 patients undergoing gastrectomy or endoscopic biopsy of suspected gastric lesions. Results High-quality Raman spectra ranging from 700 to 1800 cm-1 were acquired from the gastric tissues within 5 s. The distribution pattern of Raman spectra in gastric cancer differed significantly from those of gastric precancerous lesions and normal gastric mucosa, particularly in the spectral ranges of 853 cm-1, 936 cm-1, 1003 cm-1, 1032 cm-1, 1174 cm-1, 1208 cm-1, 1323 cm-1, 1335 cm-1, 1450 cm-1, and 1655 cm-1, which contained signals related to proteins, nucleic acids and lipids. The diagnostic decision algorithm based on the Raman peak intensity ratios of I10 3/I13 7, I10 3/I14 5, I10 3/I165 , and I1 56/I165 yielded remarkable differences in gastric cancer from gastric precancerous lesions and normal gastric mucosa, and the ratios were significantly higher in normal gastric tissues （P＆lt;0.05）. The discrimination based on near-infrared Raman spectroscopy using PCA-LDA algorithms associated with leave-one-out and cross-validation method showed diagnostic sensitivities of 81.5%, 85.3%, and 100%, and specificities of 86.4%, 100%, and 97.4%for normal gastric mucosa, precancerous lesions and gastric cancer, respectively. Conclusion near-infrared Raman spectroscopy in conjunction with intensity ratio algorithms shows the potential for noninvasive diagnosis and detection of gastric malignancy at the molecular level.