Fluorescence in situ detection of human cutaneous melanoma: study of diagnostic parameters of the method.

Multicenter study of the diagnostic parameters was conducted by three groups in Poland to determine if in situ fluorescence detection of human cutaneous melanoma based on digital imaging of spectrally resolved autofluorescence can be used as a tool for a preliminary selection of patients at increased risk of the disease. Fluorescence examinations were performed for 7228 pigmented lesions in 4079 subjects. Histopathologic examinations showed 56 cases of melanoma. A sensitivity of fluorescence detection of melanoma was 82.7% in agreement with 82.5% found in earlier work. Using as a reference only the results of histopathologic examinations obtained for 568 cases we found a specificity of 59.9% and a positive predictive value of 17.5% (melanomas versus all pigmented lesions) or 24% (melanomas versus common and dysplastic naevi). The specificity and positive predictive value found in this work are significantly lower than reported earlier but still comparable with those reported for typical screening programs. In conclusion, the fluorescence method of in situ detection of melanoma can be used in screening large populations of patients for a selection of patients who should be examined by specialists.

Detection of melanomas by digital imaging of spectrally resolved ultraviolet light-induced autofluorescence of human skin.

Digital images of autofluorescence excited with 366 nm Hg line were recorded in a narrow 475 nm band for 408 pigmented lesions of the skin (90 melanomas, 205 common melanocytic and dysplastic naevi, 113 lesions of different kinds) and analysed photometrically with respect to spatial distribution of intensity to differentiate between melanomas and other melanocytic lesions. Earlier reports describing patterns of intensity distributions characteristic for melanomas have not been confirmed in this study. However, our evaluations showed that an algorithm based on ratios of maximum intensity recorded outside the lesions and minimum intensity found within them, allows melanomas to be detected with a sensitivity of 82.5%, a specificity of 78.6% and a positive predictive value of 58.9% (melanomas versus common and dysplastic naevi) or 76.7% (melanomas versus other pigmented lesions). The method is now being tested in a multicentre study involving three groups in three different cities in Poland.

[Tissue spectroscopy. New generation of optical methods for cancer detection]. / Spektroskopia tkankowa. Nowa generacja optycznych metod wykrywania nowotworów.

Recent developments in the field of new, non-invasive, sensitive methods of cancer detection based on measurements of autofluorescence of cells are discussed. Research oriented on a detection of human cancer has been carried on by several groups for last six years only but has already yielded important data pointing to a possibility of both in situ and in vitro detection of cancerous tissues in several human organs, especially lung, gynecological tract, skin and gastro-intestinal tract. At least two such methods have been currently subject to clinical tests.