Detection of oral squamous-cell cancer and precancerous lesions by fluorescence imaging in a hamster cheek-pouch model

摘要

The role of non-skin phototoxic dose of Photofrin in the detection of dysplasia and carcinoma in situ was assessed in a small animal model of oral squamous cell cancer (SCC). Nine,10-dimethyl 1,2-benzanthracene (DMBA) impregnated cotton sutures, covered with a silicone sheath, were sewn into the hamster cheek pouch to produce dysplasia, carcinoma in situ, and invasive cancer. The yield of SCC was 83% by 20 weeks. Fluorescence imaging was performed using a specially designed device that exploits differences of fluorescence properties of normal, precancerous, and cancerous tissues with and without Photofrin. The fluorescence was induced by a helium-cadmium laser (442 nm) and then measured at two different wavelengths by an image intensified camera. Computed images using a mathematical transformation of fluorescence data were then displayed on a video monitor. Areas with dysplasia and both in situ and invasive cancers could be clearly delineated from the adjacent normal tissues. Lesions as small as 2 mm in diameter could be identified. Because of the presence of endogenous porphyrins, the addition of a non-skin phototoxic dose of Photofrin (0.25 mg/kg iv) did not enhance the signal to noise ratio. Our results suggest that fluorescence imaging can accurately detect both precancerous and cancerous lesions in the oral mucosa without exogenous porphyrins. It may have an important role as a non-invasive, clinical diagnostic tool in oropharyngeal cancer.