Can Optical Handheld Probe Based on Co-polarized and Cross-Polarized Fluorescence Spectroscopy Become the Face of Cervical Cancer Screening in Future in Developing Countries?

Abstract

To diagnose early cervical neoplasia cervical by use of in vivo handheld probe based on co-polarized and cross-polarized fluorescence spectroscopy and compare the efficacy with colposcopy and histopathology. The cross-sectional observational study was done on 49 patients who came to outpatient department in UISEMH, LLR Hospital between September 2017 to August 2019 with signs and symptoms suspicious of cervical precancerous lesions. Every patient subjected to cervical assessment as well as pelvic examination, cytology and colposcopy followed by evaluation of patient’s cervix was tested in our department by us along with the technical team from Department of Physics, IIT Kanpur, who conceptualized, designed and fabricated the optical handheld probe based on fluorescence spectroscopy. Patients were subjected to colposcopy-directed biopsy, and the sample was sent for histopathological examination in department of Pathology G.S.V.M. Medical college. The ROC curve for polarized fluorescence spectroscopy peak intensity value with co-polarized light with HPE as gold standard (CIN of any grade or CA as diseased status, otherwise the case is considered normal)) has a sensitivity 100% and specificity 88.9%. The area under the ROC curve (AUC) is 0.916 (95% CI 0.801–0.976) at an intensity of 2134.79 with p value 0.0001. The ROC curve for polarized fluorescence spectroscopy peak intensity value with cross-polarized light has sensitivity 100% and specificity 88.9% with area under the ROC curve being 0.851 (95% CI 0.721–0.937) at an intensity of 2367.54 with p value 0.0001. AUC of 0.8 implies that the technique is a good discriminator. AUC above 0.90 implies that the discriminatory power of the test technique is excellent. Thus, the in vivo use of optical handheld probe can emerge as a new screening modality thereby detecting precancerous cervical lesions timely and hence early referral to a higher centre for proper and adequate management.