Diagnosis of early stage nasopharyngeal carcinoma using ultraviolet autofluorescence excitation–emission matrix spectroscopy and parallel factor analysis

We report the diagnostic ability of ultraviolet (UV)-excited autofluorescence (AF) excitation–emission matrix (EEM) spectroscopy associated with parallel factor (PARAFAC) analysis for differentiating cancer from normal nasopharyngeal tissue. A bifurcated fiber-optic probe coupled with an EEM system was used to acquire tissue AF EEMs using excitation wavelengths between 260 and 400 nm, and emission collection between 280 and 500 nm. A total of 152 AF EEM landscapes were acquired from 13 normal and 16 nasopharyngeal carcinoma (NPC) thawed ex vivo tissue samples from 23 patients. PARAFAC was introduced for curve resolution of individual AF EEM landscapes associated with the endogenous tissue constituents. The significant factors were further fed to a support vector machine (SVM) and cross-validated to construct diagnostic algorithms. Both the EEM intensity landscapes and the PARAFAC model revealed tryptophan, collagen, and elastin to be the three major endogenous fluorophores responsible for the AF signal from normal and NPC tissues. The EEM intensity distribution and PARAFAC factors suggest an increase of tryptophan and a decrease of collagen and elastin in NPC tissues compared to the normal. The classification results obtained from the PARAFAC-SVM modeling yielded a diagnostic accuracy of 94.7% (sensitivity of 95.0% (76/80); specificity of 94.4% (68/72)) for normal and NPC tissue differentiation. This study suggests that UV-excited AF EEM spectroscopy integrated with PARAFAC algorithms has the potential to provide clinical diagnostics of early onset and progression of NPC.