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Delrue C, De Bruyne S, Oyaert M, Delanghe JR, Moresco RN, Speeckaert R, Speeckaert MM. Infrared Spectroscopy in Gynecological Oncology: A Comprehensive Review of Diagnostic Potentials and Challenges. Int J Mol Sci 2024; 25:5996. [PMID: 38892184 PMCID: PMC11172863 DOI: 10.3390/ijms25115996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
The early detection of gynecological cancers, which is critical for improving patient survival rates, is challenging because of the vague early symptoms and the diagnostic limitations of current approaches. This comprehensive review delves into the game-changing potential of infrared (IR) spectroscopy, a noninvasive technology used to transform the landscape of cancer diagnosis in gynecology. By collecting the distinctive vibrational frequencies of chemical bonds inside tissue samples, Fourier-transform infrared (FTIR) spectroscopy provides a 'molecular fingerprint' that outperforms existing diagnostic approaches. We highlight significant advances in this field, particularly the identification of discrete biomarker bands in the mid- and near-IR spectra. Proteins, lipids, carbohydrates, and nucleic acids exhibited different absorption patterns. These spectral signatures not only serve to distinguish between malignant and benign diseases, but also provide additional information regarding the cellular changes associated with cancer. To underscore the practical consequences of these findings, we examined studies in which IR spectroscopy demonstrated exceptional diagnostic accuracy. This review supports the use of IR spectroscopy in normal clinical practice, emphasizing its capacity to detect and comprehend the intricate molecular underpinnings of gynecological cancers.
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Affiliation(s)
- Charlotte Delrue
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium;
| | - Sander De Bruyne
- Department of Clinical Biology, Ghent University Hospital, 9000 Ghent, Belgium; (S.D.B.); (M.O.)
| | - Matthijs Oyaert
- Department of Clinical Biology, Ghent University Hospital, 9000 Ghent, Belgium; (S.D.B.); (M.O.)
| | - Joris R. Delanghe
- Department of Diagnostic Sciences, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium;
| | - Rafael Noal Moresco
- Graduate Program in Pharmaceutical Sciences, Center of Health Sciences, Federal University of Santa Maria, Santa Maria 72500-000, Brazil;
| | | | - Marijn M. Speeckaert
- Department of Nephrology, Ghent University Hospital, 9000 Ghent, Belgium;
- Research Foundation-Flanders (FWO), 1000 Brussels, Belgium
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Hajab H, Anwar A, Nawaz H, Majeed MI, Alwadie N, Shabbir S, Amber A, Jilani MI, Nargis HF, Zohaib M, Ismail S, Kamal A, Imran M. Surface-enhanced Raman spectroscopy of the filtrate portions of the blood serum samples of breast cancer patients obtained by using 30 kDa filtration device. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 311:124046. [PMID: 38364514 DOI: 10.1016/j.saa.2024.124046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/04/2024] [Accepted: 02/12/2024] [Indexed: 02/18/2024]
Abstract
Raman spectroscopy is reliable tool for analyzing and exploring early disease diagnosis related to body fluids, such as blood serum, which contain low molecular weight fraction (LMWF) and high molecular weight fraction (HMWF) proteins. The disease biomarkers consist of LMWF which are dominated by HMWF hence their analysis is difficult. In this study, in order to overcome this issue, centrifugal filter devices of 30 kDa were used to obtain filtrate and residue portions obtained from whole blood serum samples of control and breast cancer diagnosed patients. The filtrate portions obtained in this way are expected to contain the marker proteins of breast cancer of the size below this filter size. These may include prolactin, Microphage migration inhabitation factor (MIF), γ-Synuclein, BCSG1, Leptin, MUC1, RS/DJ-1 present in the centrifuged blood serum (filtrate portions) which are then analyzed by the SERS technique to recognize the SERS spectral characteristics associated with the progression of breast cancer in the samples of different stages as compared to the healthy ones. The key intention of this study is to achieve early-stage breast cancer diagnosis through the utilization of Surface Enhanced Raman Spectroscopy (SERS) after the centrifugation of healthy and breast cancer serum samples with Amicon ultra-filter devices of 30 kDa. The silver nanoparticles with high plasmon resonance are used as a substrate for SERS analysis. Principal Component Analysis (PCA) and Partial Least Discriminant Analysis (PLS-DA) models are utilized as spectral classification tools to assess and predict rapid, reliable, and non-destructive SERS-based analysis. Notably, they were particularly effective in distinguishing between different SERS spectral groups of the cancerous and non-cancerous samples. By comparing all these spectral data sets to each other PLSDA shows the 79 % accuracy, 76 % specificity, and 81 % sensitivity in samples with AUC value of AUC = 0.774 SERS has proven to be a valuable technique for the rapid identification of the SERS spectral features of blood serum and its filtrate fractions from both healthy individuals and those with breast cancer, aiding in disease diagnosis.
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Affiliation(s)
- Hawa Hajab
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Ayesha Anwar
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Haq Nawaz
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, Pakistan.
| | - Muhammad Irfan Majeed
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, Pakistan.
| | - Najah Alwadie
- Department of Physics, College of Science, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia.
| | - Sana Shabbir
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Arooj Amber
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | | | - Hafiza Faiza Nargis
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Muhammad Zohaib
- Department of Zoology, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Sidra Ismail
- Medical College, Foundation University Islamabad, Pakistan
| | - Abida Kamal
- Department of Chemistry, University of Agriculture Faisalabad, Faisalabad, Pakistan
| | - Muhammad Imran
- Department of Chemistry, Faculty of Science, King Khalid University, P.O. Box 9004, Abha, Saudi Arabia
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Wei CT, You JL, Weng SK, Jian SY, Lee JCL, Chiang TL. Enhancing forensic investigations: Identifying bloodstains on various substrates through ATR-FTIR spectroscopy combined with machine learning algorithms. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 308:123755. [PMID: 38101254 DOI: 10.1016/j.saa.2023.123755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/16/2023] [Accepted: 12/08/2023] [Indexed: 12/17/2023]
Abstract
The forensic analysis of bloodstains on various substrates plays a crucial role in criminal investigations. This study presents a novel approach for analyzing bloodstains using Attenuated Total Reflectance Fourier Transform Infrared spectroscopy (ATR-FTIR) in combination with machine learning. ATR-FTIR offers non-destructive and non-invasive advantages, requiring minimal sample preparation. By detecting specific chemical bonds in blood components, it enables the differentiation of various body fluids. However, the subjective interpretation of the spectra poses challenges in distinguishing different fluids. To address this, we employ machine learning techniques. Machine learning is extensively used in chemometrics to analyze chemical data, build models, and extract useful information. This includes both unsupervised learning and supervised learning methods, which provide objective characterization and differentiation. The focus of this study was to identify human and porcine blood on substrates using ATR-FTIR spectroscopy. The substrates included paper, plastic, cloth, and wood. Data preprocessing was performed using Principal Component Analysis (PCA) to reduce dimensionality and analyze latent variables. Subsequently, six machine learning algorithms were used to build classification models and compare their performance. These algorithms comprise Partial Least Squares Discriminant Analysis (PLS-DA), Decision Trees (DT), Logistic Regression (LR), Naive Bayes Classifier (NBC), Support Vector Machine (SVM), and Neural Network (NN). The results indicate that the PCA-NN model provides the optimal solution on most substrates. Although ATR-FTIR spectroscopy combined with machine learning effectively identifies bloodstains on substrates, the performance of different identification models still varies based on the type of substrate. The integration of these disciplines enables researchers to harness the power of data-driven approaches for solving complex forensic problems. The objective differentiation of bloodstains using machine learning holds significant implications for criminal investigations. This technique offers a non-destructive, simple, selective, and rapid approach for forensic analysis, thereby assisting forensic scientists and investigators in determining crucial evidence related to bloodstains.
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Affiliation(s)
- Chun-Ta Wei
- School of Defense Science, Chung Cheng Institute of Technology, National Defense University, Taoyuan 335009, Taiwan
| | - Jhu-Lin You
- Department of Chemical and Materials Engineering, Chung Cheng Institute of Technology, National Defense University, Taoyuan 335009, Taiwan; System Engineering and Technology Program, National Yang Ming Chiao Tung University, Hsinchu 300093, Taiwan
| | - Shiuh-Ku Weng
- Department of Electronic Engineering, Chien Hsin University of Science and Technology, Taoyuan 320678, Taiwan.
| | - Shun-Yi Jian
- Department of Material Engineering, Ming Chi University of Technology, New Taipei 243303, Taiwan; Center for Plasma and Thin Film Technologies, Ming Chi University of Technology, New Taipei 243303, Taiwan.
| | - Jeff Cheng-Lung Lee
- Department of Criminal Investigation, Taiwan Police College, Taipei 116078, Taiwan
| | - Tang-Lun Chiang
- School of Defense Science, Chung Cheng Institute of Technology, National Defense University, Taoyuan 335009, Taiwan
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Yuan L, Chen X, Huang Y, Chen J, Pan T. Spectral separation degree method for Vis-NIR spectroscopic discriminant analysis of milk powder adulteration. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2023; 301:122975. [PMID: 37301030 DOI: 10.1016/j.saa.2023.122975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023]
Abstract
Adulteration detection of adding ordinary milk powder to high-end dedicated milk powder is challenging due to the high similarity. Using visible and near-infrared (Vis-NIR) spectroscopy combined with k-nearest neighbor (kNN), the discriminant analysis models of pure brand milk powder and its adulterated milk powder (including unary and binary adulteration) were established. Standard normal variate transformation and Norris derivative filter (D = 2, S = 11, G = 5) were jointly used for spectral preprocessing. The separation degree and separation degree spectrum between two spectral populations were proposed and used to describe the differences between the two spectral populations, based on which, a novel wavelength selection method, named separation degree priority combination-kNN (SDPC-kNN), was proposed for wavelength optimization. SDPC-wavelength step-by-step phase-out-kNN (SDPC-WSP-kNN) models were established to further eliminate interference wavelengths and improve the model effect. The nineteen wavelengths in long-NIR region (1100-2498 nm) with a separation degree greater than 0 were used to establish single-wavelength kNN models, the total recognition-accuracy rates in prediction (RARP) all reached 100%, and the total recognition-accuracy rate in validation (RARV) of the optimal model (1174 nm) reached 97.4%. In the visible (400-780 nm) and short-NIR (780-1100 nm) regions with the separation degree all less than 0, the SDPC-WSP-kNN models were established. The two optimal models (N = 7, 22) were determined, the RARP values reached 100% and 97.4% respectively, and the RARV values reached 96.1% and 94.3% respectively. The results indicated that Vis-NIR spectroscopy combined with few-wavelength kNN has feasibility of high-precision milk powder adulteration discriminant. The few-wavelength schemes provided a valuable reference for designing dedicated miniaturized spectrometer of different spectral regions. The separation degree spectrum and SDPC can be used to improve the performance of spectral discriminant analysis. The SDPC method based on the separation degree priority proposed is a novel and effective wavelength selection method. It only needs to calculate the distance between two types of spectral sets at each wavelength with low computational complexity and good performance. In addition to combining with kNN, SDPC can also be combined with other classifier algorithms (e.g. PLS-DA, PCA-LDA) to expand the application scope of the method.
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Affiliation(s)
- Lu Yuan
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Xianghui Chen
- Department of Biological Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Yongqi Huang
- Department of Biological Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Jiemei Chen
- Department of Biological Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China
| | - Tao Pan
- Department of Optoelectronic Engineering, Jinan University, Huangpu Road West 601, Tianhe District, Guangzhou 510632, China.
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Rapid and sensitive detection of esophageal cancer by FTIR spectroscopy of serum and plasma. Photodiagnosis Photodyn Ther 2022; 40:103177. [PMID: 36602070 DOI: 10.1016/j.pdpdt.2022.103177] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022]
Abstract
Fourier transform infrared (FTIR) spectroscopy, as a platform technology for cancer detection, must be up to the challenge of clinical transformation. To this end, detection of esophageal squamous cell carcinoma (ESCC) was hereby explored using serum and plasma scrape-coated on barium fluoride (BaF2) disk by transmission FTIR method, and the classification model was built using six multivariate statistical analyses, including support vector machine (SVM), principal component linear discriminant analysis (PC-LDA), decision tree (DT), k-nearest neighbor (KNN) classification, ensemble algorithms (EA) and partial least squares for discriminant analysis (PLS-DA). All statistical analyses methods demonstrated that late-stage cancer could be well classified from healthy people employing either serum or plasma with different anticoagulants. Resulting PC-LDA model differentiated late-stage cancer from normal group with an accuracy of 99.26%, a sensitivity of 98.53%, and a specificity of 100%. The accuracy and sensitivity reached 97.08% and 91.43%, respectively for early-stage cancer discrimination from normal group. This pilot exploration demonstrated that transmission FTIR provided a rapid, cost effective and sensitive method for ESCC diagnosis using either serum or plasma.
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Wang G, Wu H, Yang C, Li Z, Chen R, Liang X, Yu K, Li H, Shen C, Liu R, Wei X, Sun Q, Zhang K, Wang Z. An Emerging Strategy for Muscle Evanescent Trauma Discrimination by Spectroscopy and Chemometrics. Int J Mol Sci 2022; 23:ijms232113489. [PMID: 36362276 PMCID: PMC9658611 DOI: 10.3390/ijms232113489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/28/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
Trauma is one of the most common conditions in the biomedical field. It is important to identify it quickly and accurately. However, when evanescent trauma occurs, it presents a great challenge to professionals. There are few reports on the establishment of a rapid and accurate trauma identification and prediction model. In this study, Fourier transform infrared spectroscopy (FTIR) and microscopic spectroscopy (micro-IR) combined with chemometrics were used to establish prediction models for the rapid identification of muscle trauma in humans and rats. The results of the average spectrum, principal component analysis (PCA) and loading maps showed that the differences between the rat muscle trauma group and the rat control group were mainly related to biological macromolecules, such as proteins, nucleic acids and carbohydrates. The differences between the human muscle trauma group and the human control group were mainly related to proteins, polysaccharides, phospholipids and phosphates. Then, a partial least squares discriminant analysis (PLS-DA) was used to evaluate the classification ability of the training and test datasets. The classification accuracies were 99.10% and 93.69%, respectively. Moreover, a trauma classification and recognition model of human muscle tissue was constructed, and a good classification effect was obtained. The classification accuracies were 99.52% and 91.95%. In conclusion, spectroscopy and stoichiometry have the advantages of being rapid, accurate and objective and of having high resolution and a strong recognition ability, and they are emerging strategies for the identification of evanescent trauma. In addition, the combination of spectroscopy and stoichiometry has great potential in the application of medicine and criminal law under practical conditions.
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Wang G, Cai W, Wu H, Yang C, Yu K, Liu R, Wei X, Lin H, Sun Q, Wang Z. Identification of human and non-human bloodstains on rough carriers based on ATR-FTIR and chemometrics. Microchem J 2022. [DOI: 10.1016/j.microc.2022.107620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ye N, Zhong S, Fang Z, Gao H, Du Z, Chen H, Yuan L, Pan T. Performance Improvement of NIR Spectral Pattern Recognition from Three Compensation Models’ Voting and Multi-Modal Fusion. Molecules 2022; 27:molecules27144485. [PMID: 35889356 PMCID: PMC9321551 DOI: 10.3390/molecules27144485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 12/10/2022] Open
Abstract
Inspired by aquaphotomics, the optical path length of measurement was regarded as a perturbation factor. Near-infrared (NIR) spectroscopy with multi-measurement modals was applied to the discriminant analysis of three categories of drinking water. Moving window-k nearest neighbor (MW-kNN) and Norris derivative filter were used for modeling and optimization. Drawing on the idea of game theory, the strategy for two-category priority compensation and three-model voting with multi-modal fusion was proposed. Moving window correlation coefficient (MWCC), inter-category and intra-category MWCC spectra, and k-shortest distances plotting with MW-kNN were proposed to evaluate weak differences between two spectral populations. For three measurement modals (1 mm, 4 mm, and 10 mm), the optimal MW-kNN models, and two-category priority compensation models were determined. The joint models for three compensation models’ voting were established. Comprehensive discrimination effects of joint models were better than their sub-models; multi-modal fusion was better than single-modal fusion. The best joint model was the dual-modal fusion of compensation models of one- and two-category priority (1 mm), one- and three-category priority (10 mm), and two- and three-category priority (1 mm), validation’s total recognition accuracy rate reached 95.5%. It fused long-wave models (1 mm, containing 1450 nm) and short-wave models (10 mm, containing 974 nm). The results showed that compensation models’ voting and multi-modal fusion can effectively improve the performance of NIR spectral pattern recognition.
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ATR-IR Spectroscopy Application to Diagnostic Screening of Advanced Endometriosis. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:4777434. [PMID: 35707272 PMCID: PMC9192200 DOI: 10.1155/2022/4777434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/13/2022] [Accepted: 05/19/2022] [Indexed: 11/18/2022]
Abstract
Endometriosis is one of the most common gynecological diseases among young women of reproductive age. Thus far, it has not been possible to define a parameter that is sensitive and specific enough to be a recognized biomarker for diagnosing this disease. Nonspecific symptoms of endometriosis and delayed diagnosis are impulses for researching noninvasive methods of differentiating endometriosis from other gynecological disorders. We compared three groups of individuals in our research: women with endometriosis (E), patients suffering from other gynecological disorders (nonendometriosis, NE), and healthy women from the control group (C). Partial least squares discriminant analysis (PLS-DA) models were developed based on selected serum biochemical parameters, specific regions of the serum’s infrared attenuated total reflectance (FTIR ATR) spectra, and combined data. Incorporating the spectral data into the models significantly improved differentiation among the three groups, with an overall accuracy of 87.5%, 97.3%, and 98.5%, respectively. This study shows that infrared spectroscopy and discriminant analysis can be used to differentiate serum samples among women with advanced endometriosis, women without this disease, i.e., healthy women, and, most importantly, also women with other benign gynecological disorders.
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Schiemer R, Furniss D, Phang S, Seddon AB, Atiomo W, Gajjar KB. Vibrational Biospectroscopy: An Alternative Approach to Endometrial Cancer Diagnosis and Screening. Int J Mol Sci 2022; 23:ijms23094859. [PMID: 35563249 PMCID: PMC9102412 DOI: 10.3390/ijms23094859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 01/27/2023] Open
Abstract
Endometrial cancer (EC) is the sixth most common cancer and the fourth leading cause of death among women worldwide. Early detection and treatment are associated with a favourable prognosis and reduction in mortality. Unlike other common cancers, however, screening strategies lack the required sensitivity, specificity and accuracy to be successfully implemented in clinical practice and current diagnostic approaches are invasive, costly and time consuming. Such limitations highlight the unmet need to develop diagnostic and screening alternatives for EC, which should be accurate, rapid, minimally invasive and cost-effective. Vibrational spectroscopic techniques, Mid-Infrared Absorption Spectroscopy and Raman, exploit the atomic vibrational absorption induced by interaction of light and a biological sample, to generate a unique spectral response: a “biochemical fingerprint”. These are non-destructive techniques and, combined with multivariate statistical analysis, have been shown over the last decade to provide discrimination between cancerous and healthy samples, demonstrating a promising role in both cancer screening and diagnosis. The aim of this review is to collate available evidence, in order to provide insight into the present status of the application of vibrational biospectroscopy in endometrial cancer diagnosis and screening, and to assess future prospects.
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Affiliation(s)
- Roberta Schiemer
- Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham NG5 1PB, UK;
- Correspondence:
| | - David Furniss
- Mid-Infrared Photonics Group, George Green Institute for Electromagnetics Research, Faculty of Engineering, University of Nottingham, Nottingham NG7 2RD, UK; (D.F.); (S.P.); (A.B.S.)
| | - Sendy Phang
- Mid-Infrared Photonics Group, George Green Institute for Electromagnetics Research, Faculty of Engineering, University of Nottingham, Nottingham NG7 2RD, UK; (D.F.); (S.P.); (A.B.S.)
| | - Angela B. Seddon
- Mid-Infrared Photonics Group, George Green Institute for Electromagnetics Research, Faculty of Engineering, University of Nottingham, Nottingham NG7 2RD, UK; (D.F.); (S.P.); (A.B.S.)
| | - William Atiomo
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates;
| | - Ketankumar B. Gajjar
- Division of Child Health, Obstetrics and Gynaecology, University of Nottingham, Nottingham NG5 1PB, UK;
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