Discrimination of healthy and cancer cells of the bladder by metabolic state, based on autofluorescence

S. Palmer, K. Litvinova, E.U. Rafailov, G. Nabi

Research output: Chapter in Book/Published conference outputConference publication


Bladder cancer is among the most common cancers worldwide (4th in men). It is responsible for high patient morbidity and displays rapid recurrence and progression. Lack of sensitivity of gold standard techniques (white light cystoscopy, voided urine cytology) means many early treatable cases are missed. The result is a large number of advanced cases of bladder cancer which require extensive treatment and monitoring. For this reason, bladder cancer is the single most expensive cancer to treat on a per patient basis. In recent years, autofluorescence spectroscopy has begun to shed light into disease research. Of particular interest in cancer research are the fluorescent metabolic cofactors NADH and FAD. Early in tumour development, cancer cells often undergo a metabolic shift (the Warburg effect) resulting in increased NADH. The ratio of NADH to FAD ("redox ratio") can therefore be used as an indicator of the metabolic status of cells. Redox ratio measurements have been used to differentiate between healthy and cancer breast cells and to monitor cellular responses to therapies. Here, we have demonstrated, using healthy and bladder cancer cell lines, a statistically significant difference in the redox ratio of bladder cancer cells, indicative of a metabolic shift. To do this we customised a standard flow cytometer to excite and record fluorescence specifically from NADH and FAD, along with a method for automatically calculating the redox ratio of individual cells within large populations. These results could inform the design of novel probes and screening systems for the early detection of bladder cancer.

Original languageEnglish
Title of host publicationPhotonic therapeutics and diagnostics XI
EditorsBernard Choi, Nikiforos Kollias, Haishan Zeng, et al
Number of pages6
ISBN (Print)978-1-2841393-9
Publication statusPublished - 26 Feb 2015
EventPhotonic Therapeutics and Diagnostics XI - San Francisco, United States
Duration: 7 Feb 20158 Feb 2015

Publication series

NameSPIE proceedings
ISSN (Print)0277-786X
NameProgress in biomedical optics and imaging
ISSN (Print)1605-7422


ConferencePhotonic Therapeutics and Diagnostics XI
Country/TerritoryUnited States
CitySan Francisco

Bibliographical note

S. Palmer ; K. Litvinova ; E. U. Rafailov and G. Nabi, "Discrimination of healthy and cancer cells of the bladder by metabolic state, based on autofluorescence", Proc. SPIE 9303, Photonic Therapeutics and Diagnostics XI, 93030T (February 26, 2015)

Copyright 2015 Society of Photo-Optical Instrumentation Engineers. One print or electronic copy may be made for personal use only. Systematic reproduction and distribution, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited.

DOI: http://dx.doi.org/10.1117/12.2077218

Funding: EU FP7 project ABLADE (Advanced Bladder cancer Diagnosis and Therapy) with further contribution from NHS and EPSRC.


  • autofluorescence
  • bladder cancer
  • cytometry
  • metabolism
  • Redox ratio


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