Study On Urine Intrinsic Fluorescence For Gynecological Tumors Diagnosis

The Gynecologic cancer is one of the most common malignant tumors in the world, and its incidence rate increases obviously in recent years. A valid examination and diagnosis for early stage gynecologic cancer (especially ovarian cancer) has not been found at present, so it is necessary to search for a new method. Considering the close affinity between female reproductive organ and urinary system, the morning void urine spectral analysis from gynecologic cancer patients may be helped to preliminarily find the state of pathological change. This may provide an assistant screening method for the early diagnosis of gynecologic cancer.The UV-Visible absorption and auto-fluorescence spectra of urine for 16 pieces of normal women and 21 pieces of gynecologic cancer patients in the experiment are measured by the Fiber Optic Spectrometer system and Roper Scientific SP-2558 spectrometer. The spectra are analyzed theoretically and experimentally. It is found that:1) Urine absorption spectra within 200~400nm consist of three absorption bands: A216, A260 and A315. The three absorption bands are correspond separately with protein, riboflavin and the reduced form of nicotinamide adenine dinucleotide (NADH) and the oxidized form of nicotinamide adenine dinucleotide (NAD+), which form the metabolic intermediate of kidney. These absorption spectra have almost similar line shapes and physical parameter at A216, A260.2) The urine absorption spectral peak of normal group descends faster than that of cancer group at the peak A315. Resulting calculation indicates that the relative content of substances correspond with the peak A315 is lower in cancer patients than healthy women. It may predicate some pathological changes and be one of diagnosis factors for gynecologic cancer.3) The ultraviolet excited urine fluorescence spectra consist of four peaks at 458nm, 520nm, 612nm and 674nm. They come from the fluorophores of NADH, NAD+, riboflavin and coproporphyrin. The coproporphyrin fluorescence peaks are at 612nm and 674nm. The theoretical calculation shows that the NADH and NAD+ in urine may play an important role on the fluorescence-quantum yield. Integral intensities of NADH peak accounting for 57% of spectral total.4) The fluorescence intensity of NADH increase with the rise of woman age. It indicates that the concentration of NADH in the urine is rising along with women consenescence and the degeneration of kidney metabolic function. So it may provide a new diagnostic method for some diseases resulted from the metabolic disorders of kidney.5) The FWHM of gynecologic cancer group is wider than normal group and suspected group, and the ratio of the integration area is smaller. Based on this result, the identified rate of the experiment samples reache 100%6) First order derivative spectrophotometry was performed to extract the information of spectra under 340nm excitation. It is found the fluorescence excitation-emission matrix taken from the urine of tumor and normal groups are different from each other. Using the clinical medicine golden rule to cluster analysis the information, theγ= 300 was set as a basis for judgment. The sensitivity and specificity of the classification are separately 80.95%, 75%. According to the differences in the spectra, the intrinsic fluorescence spectroscopy has the potential ability to help to diagnose early gynecologic cancer.