In vivo detection of oral precancer using a fluorescence-based, in-house-fabricated device: a Mahalanobis distance-based classification
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In vivo detection of oral precancer has been carried out by a fluorescence-based, in-house-developed handheld probe on three groups: oral squamous cell carcinoma (OSCC), dysplastic (precancer), and control (normal). Measurements have been performed on a total of 141 patients and volunteers of different age groups. Excitation wavelength of 405 nm was used and fluorescence emission spectra were recorded in the scan range of 450.14 to 763.41 nm at very low incident power (122 μW) from different oral sites buccal mucosa (BM), lateral boarder of tongue (LBT), and dorsal surface of tongue (DST). Spectral profiles are found to vary among the three groups as well as among the different oral sites. Major and minor bands of flavin adenine dinucleotide (FAD) and porphyrins near 500, 634, 676, 689, and 703 nm have been obtained. Porphyrin contribution is found to be more dominant than the FAD in OSCC and dysplastic groups as compared to the control group. A better classification has been observed using the entire spectral range rather than restricting to individual bands, by application of principal component analysis (PCA), Mahalanobis distance model, and receiver operating characteristic analysis (ROC). ROC on Mahalanobis distance differentiates OSCC to normal, dysplastic to normal, and OSCC to dysplastic with sensitivities from 71% to 98%, 92% to 94% and 81% to 93% and specificities 91% to 100%, 86% to 100% and 79% to 97% for oral sites BM, LBT and DST. LBT and DST appear to be more sensitive to dysplasia detection as compared to BM.
KeywordsOral cancer Oral sites Fluorescence spectroscopy Principle component analysis Mahalanobis distance model Receiver operating characteristic analysis
We would like to acknowledge IMPRINT India, MHRD government, for the financial support.
Compliance with ethical standards
Conflict of interest statement
The authors declare that they have no conflicts of interest.
Role of funding source
Facilities of Biophotonics lab at IIT Kanpur has been utilized in the study.
The study was approved by the Ethics Committee of GSVM Medical College Kanpur and IIT Kanpur and performed in accordance with the Declaration of Helsinki.
Informed consent form was taken from all participating patients and volunteers.
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