Lithuanian Journal of Physics article / Lietuvos fizikos žurnalo straipsnis

METHODS FOR AUTOFLUORESCENCE ANALYSIS OF UTERINE CAVITY WASHINGS
Vilmantas Gėgžna^a,b, Povilas Sladkevičius^c, Lil Valentin^c, and Aurelija Vaitkuvienė^a ^aInstitute of Applied Research, Vilnius University, Saulėtekio 9, LT-10222 Vilnius, Lithuania
E-mail: aurelija.vaitkuviene@tmi.vu.lt
^bFaculty of Natural Sciences, Vilnius University, M.K. Čiurlionio 21/27, LT-03101 Vilnius, Lithuania
^cDepartment of Obstetrics and Gynecology, Skåne University Hospital, Lund University, Malmö, Sweden

Received 12 November 2014; revised 26 February 2015; accepted 20 March 2015

The diagnostics of endometrial pathology can be done by obtaining information at the molecular level, e. g. using the autofluorescence-based technique. Thus, for the first time an experimental study was performed on waste material of uterine cavity washing specimens to evaluate suitability of the technique for diagnostics. The specimens were obtained from 32 patients who had a conventional uterine hydrosonography procedure. A portable Nd:YAG 355 nm microlaser was used to excite autofluorescence at the point of care. Various algorithms of multivariate curve resolution and artificial neural networks were utilized for spectra analysis. The spectra were classified according to histological and ultrasound diagnosis. Receiver operating characteristic (ROC) curve analysis was used to make statistical decisions. The results showed that it was possible to distinguish all compared groups: pathologic vs non-pathologic endometrium (sensitivity 97.3 ± 5.2%, specificity 91.7 ± 7%, AUC (area under the ROC curve) 0.96 ± 0.04), malignant endometrium vs endometrial polyps (sensitivity 100 ± 0%, specificity 92.0 ± 10.6%, AUC = 0.98 ± 0.07), and secretory menstrual cycle phase vs proliferative phase (sensitivity 87.5 ± 13.2%, specificity 94.4 ± 7.4%, AUC = 0.88 ± 0.10). To conclude, uterine cavity washing specimens could be used for endometrial pathology recognition using the autofluorescence-based technique in clinical setting. It will possibly speed up the treatment decision making for endometrial pathology.

Keywords: endometrium, tissue fluorescence, photodiagnostics, multivariate analysis
PACS: 02.50.Sk, 42.62.Be, 87.15.A-

GIMDOS ERTMĖS NUOPLOVŲ AUTOFLUORESCENCIJOS ANALIZĖS METODIKA

Vilmantas Gėgžna^a,b, Povilas Sladkevičius^c, Lil Valentin^c, Aurelija Vaitkuvienė^a
^aVilniaus universiteto Taikomųjų mokslų institutas, Vilnius, Lietuva
^bVilniaus universiteto Gamtos mokslų fakultetas, Vilnius, Lietuva
^cSkonės universitetinės ligoninės Akušerijos ir ginekologijos skyrius, Lundo universitetas, Malmė, Švedija

Gimdos gleivinės patologiją parodo molekulinio lygio pakitimai, kuriuos galima nustatyti naudojant informaciją, gaunamą autofluorescencijos reiškiniu pagrįstais metodais. Šiame darbe pirmą kartą atlikta naujo tipo bandinių – nuoplovų nuosėdų, gaunamų po standartinio kontrastinio ultragarsinio gimdos tyrimo (hidrosonografijos), – analizė. Darbo tikslas – išbandyti gimdos gleivinės ligų diagnostikos metodiką. Eksperimentai atlikti tiriant 32 pacienčių gimdos ertmės nuoplovas. Fluorescencija žadinta 355 nm nešiojamojo lazerio spinduliuote. Spektrų analizei naudoti pagrindinių komponentų bei kiti spektrų skaidymo į komponentus metodai, dirbtinių neuroninių tinklų algoritmas. Statistiniam sprendimui priimti naudota stebėtojo operacinės charakteristikos (ROC) kreivių analizė. Tikrosios medicininės diagnozės nustatytos ištyrus histologijos ir ultragarso tyrimais. Taikyta metodika buvo galima identifikuoti visas tarpusavyje lygintas medicinines grupes: patologinius gimdos gleivinės pakitimus atskirti nuo sveikos gleivinės (jautrumas 97,3 ± 5,2 %, specifiškumas 91,7 ± 7 %, AUC (t. y. plotas po ROC kreive) – 0,96 ± 0,04), piktybinius pakitimus nuo polipų (jautrumas 100 ± 0 %, specifiškumas 92,0 ± 10,6 %, AUC – 0,98 ± 0,07), sekrecinę mėnesinių ciklo fazę nuo proliferacinės (jautrumas 87,5 ± 13,2 %, specifiškumas 94,4 ± 7,4 %, AUC = 0,88 ± 0,10). Rezultatai rodo, kad metodika potencialiai galėtų būti naudojama endometriumo ligoms greitai ir preliminariai diagnozuoti, t. y. būtų atliekama pacienčių apsilankymo pas gydytoją metu.

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