Porphyrin-like fluorescence in oral cancer: In vivo fluorescence spectral characterization of lesions by use of a near-ultraviolet excited autofluorescence diagnosis system and separation of fluorescent extracts by capillary electrophoresis.

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Red fluorescence from malignant tumors was observed in experimentally induced rat sarcoma by Policard (1924) and in ulcerated human oral carcinoma by Harris et al. (1987) by examination with ultraviolet (UV) irradiation. The objective of the current study was twofold: to examine in vivo the spectral characteristics of red fluorescence emitted from oral carcinomas and to separate the red fluorescent compounds in these lesions by the capillary electrophoretic (CE) method. In vivo fluorescence spectral characteristics of oral carcinoma were examined by a near-UV excited autofluorescence diagnosis (NEAD) system developed by the authors. Fluorescence spectra of the extract from carcinomas were measured using a spectrofluorometer. CE was used to separate fluorescent compounds from the oral carcinomas. Of the 78 oral carcinomas examined using the NEAD system, 66 carcinomas (85%), including 2 adenoid cystic carcinomas (ACCs) and 14 recurrent squamous cell carcinomas (SCCs), showed porphyrin-like fluorescence spectra. The CE study was performed on three oral SCCs, two of which contained fluorescent compounds other than protoporphyrin IX and zinc protoporphyrin IX, whereas the other SCCs contained the compounds with the same migration time as protoporphyrin IX. Seventy-eight oral carcinomas, including ACCs and recurrent SCCs, were examined using the NEAD system. When exposed to UV light at a wavelength of 410 nm, 85% of the carcinomas showed porphyrin-like fluorescence spectra, whereas the normal mucosa in the oral cavity did not. Porphyrin-like fluorescent compounds were extracted from oral carcinomas and separated by a CE system equipped with a fluorescence detector. The CE data clearly show that compounds vary in each individual carcinoma.