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3. MEDICAL AND HEALTH SCIENCES
The branch of cytology known as cytopathology, studies and diagnoses diseases at a cellular level, and is a useful method for detecting cancer. The procedures used to attain cytological samples for diagnostic purposes, such as aspiration and exfoliative methods are safe, accurate and cost-effective. Histochemical and immunohistochemical (IHC) techniques are commonly applied to cytological samples to aid cancer diagnosis, however multiple limitations occur using these methods for the diagnosis of thyroid cancer (TC) and non-small cell lung cancer (NSCLC). Fine needle aspiration cytology (FNAC) is the prominent diagnostic method used for the initial investigation of thyroid nodules but is limited by the inability to accurately diagnose malignancy in follicular-patterned lesion. As a result, more than 20% of cases under investigation for TC are classified as cytologically “indeterminate”, requiring surgical resection for accurate diagnosis. In the case of NSCLC, with the advent of targeted therapies, it is imperative to accurately differentiate (NSCLC) subtypes in order to ensure efficacy of treatment for patients. Immunohistochemistry and molecular techniques are increasingly part of the diagnostic work-up of NSCLC patients however due to the limitation of small sample size, overlapping morphological features and molecular characterisation, differential diagnosis of NSCLC still proves challenging. Raman spectroscopy has shown promising results for the detection of a variety of cancers, however to date there has been no evaluation of Raman spectroscopy on cytology bronchoscopy samples or thyroid FNAC samples, which may eliminate the limitations of current methods. This thesis explores the use of Raman spectroscopy as an alternative or adjunct tool for the diagnosis of TC and NSCLC using cytological specimens.
O.Dea, D. (2020) Raman Microspectroscopy for the Discrimination of Thyroid and Lung Cancer Subtypes for Application in Clinical Cytopathology , Doctoral Thesis, Technological University Dublin. DOI:10.21427/jknp-x470