皮肤自体荧光检测技术在疾病诊断中的应用

doi:10.3969/j.issn.1674-8115.2021.02.020

摘要/Abstract

摘要：

皮肤是人体最大的器官，其组织学改变既可能为局部病变，也可以是全身性疾病的局部反应。皮肤内的部分分子可以吸收特定波长的激发光并发射波长更长的发射光，这些分子被称为内源性荧光团，产生的发射光即为皮肤自体荧光（skin autofluorescence，SAF）。不同的内源性荧光团具有其特定的荧光光谱。皮肤发生病理改变后，皮肤内的某些内源性荧光团的含量会发生变化，甚至产生新的内源性荧光团。SAF检测技术是一种无创、便捷、低成本、无毒性和不良反应的光学检测手段，包括自体荧光显像和自体荧光光谱分析。它通过分析皮肤不同内源性荧光团的荧光强度以及激发光和发射光的光谱，评估皮肤的病理改变，在多种皮肤疾病的诊断和鉴别诊断中发挥重要且独特的作用，特别是疾病的早期诊断及治疗后长期随访评估。目前，SAF技术可用于鉴别银屑病、特应性皮炎、接触性皮炎等多种炎症性皮肤病以及监测治疗效果，定量评估皮肤伤口愈合及瘢痕纤维化情况并预测形成瘢痕的类型，量化或校准皮肤老化及光老化，鉴别诊断不同种类皮肤良恶性肿瘤和在外科手术中指导皮肤肿瘤切除范围等。除皮肤病领域外，由晚期糖基化终末产物产生的SAF还可以作为内分泌系统、神经系统、心血管系统、泌尿系统等多种系统疾病的风险分级指标之一。文章简要介绍了SAF检测技术的原理，对以往SAF检测技术在各类皮肤病诊断中的应用进行回顾和总结，介绍了其在其他系统疾病中的应用，并对SAF检测技术未来的发展前景做出展望，以期为相关医学领域提供参考。

关键词: 皮肤自体荧光, 荧光光谱, 炎症性皮肤病, 皮肤恶性肿瘤, 伤口愈合, 老化, 光老化

Abstract:

Skin is the largest organ of human body. Its histological changes may reflect local lesions and serve as the manifestation of systemic diseases. Some molecules in the skin can absorb exciting light of a specific wavelength and emit emission light with a longer wavelength. These molecules are called endogenous fluorophores, and the emission light is called skin autofluorescence (SAF). Different endogenous fluorophore has its specific fluorescence spectrum. When the skin undergoes pathological changes, the content of certain endogenous fluorophores in the skin will change, and even new endogenous fluorophores will be produced. SAF detection technique is a non-invasive, convenient and low-cost optical measurement without toxic side effects, which contains autofluorescence imaging and autofluorescence spectroscopy. It plays a vital and distinctive role in the diagnosis and differential diagnosis of various skin diseases and evaluation of skin pathological changes by analyzing the fluorescence intensity and the excitation or emission spectrum of skin endogenous fluorophores, especially in the early diagnosis of the disease and long-term follow-up after treatment. So far, SAF technology has been used in differential diagnosis of psoriasis, atopic dermatitis, contact dermatitis and other types of inflammatory dermatosis, in monitoring the treatment effect, quantitatively evaluating skin wound healing and scar fibrosis and predicting the type of scar formation, in quantifying and calibrating skin aging and photoaging, in differential diagnosis of multiple types of benign or malignant skin tumors, in guidance of the scope of resection in surgical operations, etc. In addition, SAF produced by advanced glycation end products can also be used as one of the risk grading indicators for various system diseases such as endocrine system, nervous system, cardiovascular system, and urinary system. This article briefly introduces the principle of SAF detection techique, reviews the application of SAF technology to the diagnosis of diseases, supplements the application of other systemic diseases and provides an outlook on the future development of SAF detection technique, in order to provide reference for related medical fields.

Key words: skin autofluorescence (SAF), fluorescence spectrum, inflammatory dermatosis, skin malignancy, wound healing, aging, photoaging

中图分类号:

R445

郭林秀美, 章一新. 皮肤自体荧光检测技术在疾病诊断中的应用[J]. 上海交通大学学报(医学版), 2021, 41(2): 251-256.

Lin-xiu-mei GUO, Yi-xin ZHANG. Application of skin autofluorescence detection technique to diagnosis of diseases[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(2): 251-256.

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