Abstract [eng] |
sensitized fluorescence diagnostics is based on selective accumulation of photosensitizer in the tissue where carcinogenesis has started. The present study compared topical 5-aminolevulinic acid (5-ALA)-based fluorescence spectroscopy in vivo with conventional colposcopy for cervical intraepithelial neoplasia (CIN) detection. We enrolled 48 patients who were referred for colposcopy because of high-grade changes in cervical cytology. Every inspected cervix was divided in to quadrants, and there were 174 quadrants included in the study. Cytological smear, colposcopy, autofluorescence, sensitized fluorescence spectroscopy and histopathological analysis was done for each patient. For sensitized fluorescence spectroscopy 3% 5-ALA cream was used topically and after an average 135 min incubation, fluorescence spectra were recorded from the cervix in vivo. Autofluorescence, sensitized fluorescence spectroscopy and colposcopy results were correlated with histopathology. All spectra were evaluated by a ratio of the protoporphyrin IX fluorescence intensity at 634 nm and autofluorescence intensity at 510 nm. For proper grouping of low-risk and high-risk cases, a threshold value of 3.87 was calculated. 5-ALA-based sensitized fluorescence spectroscopy is an objective method, requiring short-term administration for appropriate fluorescence measurements. Sensitized fluorescence spectroscopy is a promising diagnostic tool with similar accuracy as colposcopy but with the potential advantage of providing objective results. |