Methods for autofluorescence analysis of uterine cavity washings

Abstract

The diagnostics of endometrial pathology can be done by obtaining information at the molecular level, e. g. using the autofluorescence-based technique. Thus, for the first time an experimental study was performed on waste material of uterine cavity washing specimens to evaluate suitability of the technique for diagnostics. The specimens were obtained from 32 patients who had a conventional uterine hydrosonography procedure. A portable Nd:YAG 355 nm microlaser was used to excite autofluorescence at the point of care. Various algorithms of multivariate curve resolution and artificial neural networks were utilized for spectra analysis. The spectra were classified according to histological and ultrasound diagnosis. Receiver operating characteristic (ROC) curve analysis was used to make statistical decisions. The results showed that it was possible to distinguish all compared groups: pathologic vs non-pathologic endometrium (sensitivity 97.3  ±  5.2%, specificity 91.7  ±  7%, AUC (area under the ROC curve) 0.96 ± 0.04), malignant endometrium vs endometrial polyps (sensitivity 100 ± 0%, specificity 92.0 ± 10.6%, AUC = 0.98 ± 0.07), and secretory menstrual cycle phase vs proliferative phase (sensitivity 87.5 ± 13.2%, specificity 94.4 ± 7.4%, AUC = 0.88 ± 0.10). To conclude, uterine cavity washing specimens could be used for endometrial pathology recognition using the autofluorescencebased technique in clinical setting. It will possibly speed up the treatment decision making for endometrial pathology.