Raman exfoliative cytology for prognosis prediction in oral cancers: A proof of concept study

Abstract

Oral cancer is associated with high rates of recurrence, attributable to field cancerization. Early detection of advanced field changes that can potentially progress to carcinoma can facilitate timely intervention and can lead to improved prognosis. Previous in vivo studies have successfully detected advanced field effects in oral cancers. Raman exfoliative cytology has previously shown to differentiate normal, oral precancer and cancers. The present study explores Raman-exfoliative-cytology-based detection of field effects. Exfoliated cells were collected from tumor (n = 16) and contralateral-normal appearing mucosa (n = 16) of oral cancer patients, and healthy tobacco habitués (n = 20). After spectral acquisition, specimens were Papstained for cytological evaluation. Data analysis, by Principal Component Analysis and Principal Component-Linear Discriminant Analysis, indicate several spectralmisclassifications between contralateral normal and tumor, which were investigated and correlated with spectral, cytological and clinical outcomes. A qualitative analysis by grouping patients with number of misclassifications with tumor (Group 1: 0, Group 2: 1 and Group 3: >1) was explored. Group 3 with highest misclassifications showed spectral and cytological similarity to tumor groupone patient was a case of early inoperable residual disease, despite clear margins on histopathology.Thus, these misclassifications could be indicative of cancer field changes, and can prospectively help to identify patients susceptible to recurrences. K E Y W O R D Sfield cancerization, oral cancers, pap staining, Raman exfoliative cytology, Raman spectroscopy

The accuracy of Raman spectroscopy in the detection and diagnosis of oral cancer: A systematic review and meta‐analysis

“…Among the 38 studies in the oral cancer group, 5 [33,53,54,56,60] studies evaluated in vivo tissue, whereas 33 [1,[21][22][23][24][25][26][27][28][29][30][31][32][34][35][36][37][38][39][40][41][42][43][44][45][49][50][51][52]55,[57][58][59] studies evaluated in vitro samples. in vitro samples can be categorized as tissues (n = 13), [1,21,22,24,26,27,30,39,[43][44][45]50,55] bio fluids (n = 15),…”

“…in vitro samples can be categorized as tissues (n = 13), [1,21,22,24,26,27,30,39,[43][44][45]50,55] bio fluids (n = 15), [23,25,31,32,[35][36][37][40][41][42]49,51,[57][58][59] and exfoliated cells (n = 6), [25,28,29,34,38,52] and the tissue group can be divided into a fresh tissue group (n = 5), [21,22,30,45,55] frozen tissue group (n = 7), [1,24,26,27,39,44,50] and dehydrated tissue group (n = 1) [43] (one study [25] had subgroups). A variety of diagnostic algorithms were used to analyze the RS results; most studies used principal component analysis (PCA) and linear discriminate analysis (LDA; n = 14)…”

“…Of the 38 studies that were identified through our search and included in the oral cancer group, 13 [26,27,33,35,37,[52][53][54][56][57][58][59][60] had an overall quality score of 11 (78.6% YES rate), and 15 [21,22,25,30,34,36,38,41,42,44,45,[49][50][51]55] had a score of 10 (71.4% YES rate). In addition, 10 [1,23,24,28,29,31,32,39,41,43] studies scored only a 9 (64.3% YES rate).…”

“…Oral cancer group Six [25,28,29,34,38,52] studies examined exfoliated cell samples in vitro. The coalescent sensibility and specificity for RS were 0.84 (95% CI [0.80, 0.86], p = .0000, I 2 = 92.6%) and 0.85 (95% CI [0.82, 0.88], p = .0000, I 2 = 91.7%), respectively ( Figure S3).…”

Raman Spectroscopy: An Exploratory Study to Identify Post-Radiation Cell Survival

“…This approach has been successfully verified in mixed cell populations, for the delineation of drug resistant and radioresistant phenotypes, in addition to an investigation of cervical and oral cancer specimens. 26,38–46…”