Characterization of different tissue changes in normal, betel chewers, potentially malignant lesions, conditions and oral squamous cell carcinoma using reflectance confocal microscopy: Correlation with routine histopathology
Characterization of different tissue changes in normal, betel chewers, potentially malignant lesions, conditions and oral squamous cell carcinoma using reflectance confocal microscopy: Correlation with routine histopathology
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DOI：
10.1016/j.oraloncology.2009.12.008
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发表时间：
2010-04-01
期刊：
影响因子：
4.8
通讯作者：
Chandrasekar, T.
中科院分区：
文献类型：
--
作者：
Anuthama, Krishnamurthy;Sherlin, Herald J.;Chandrasekar, T.
本研究的目的是表征正常粘膜，槟榔咀嚼者和吸烟者的粘膜，潜在的恶性病变和鳞状细胞癌的口腔粘膜的特征，使用反射共聚焦microscopic.Oral腔活检获得从25例患者的口腔外科学院，Saveetha大学谁进行了筛选可疑病变的口腔癌前病变和口腔癌沿着正常患者谁经历了嵌塞。从临床可疑区域采集活检组织，并立即置于Dulbecco改良的Eagle生长培养基（DMEM）中。反射共焦图像在多个图像平面深度从活检6小时内切除。成像后，将活检组织固定在10%福尔马林中，并由经验丰富的口腔颌面病理学家进行常规组织病理学检查。将反射共聚焦图像与来自相同样本的组织学图像进行比较，以确定有助于早期细胞变化、图像对比度和早期诊断的组织特征。在完整活检标本上获得高达150微米的深度的共聚焦图像，以及随后的三维图像、角蛋白厚度测量、细胞测量，使用Leica图像分析软件进行细胞密度分析和图示。在正常粘膜中，角蛋白沉积被视为交替的暗和亮堆叠，在不同的细胞层中，核被视为不同强度的圆盘。在癌前病变的角蛋白厚度和细胞核密度被发现增加时，与正常对照组相比。在OSMF病例中，纤维化的共聚焦图像显示单个纤维的散射作为高密度区域。口腔鳞状细胞癌的病例表现出广泛的变化，细胞大小，核大小和核形态。在细胞水平，不典型增生的功能，如核密度增加，核质比增加，核和细胞的多形性与损失的凝聚力被确定在所有五个cases.Our结果支持的潜力，反射共聚焦显微镜在口腔病变的临床评价，潜在的恶性和恶性口腔病变的早期诊断和肿瘤边缘的真实的时间识别发挥重要作用。(C)2010爱思唯尔有限公司版权所有。
The goal of this study was to characterize the features of normal mucosa, mucosa in betel chewers and smokers, potentially malignant lesions and squamous cell carcinoma of oral mucosa using reflectance confocal microscopy.Oral cavity biopsies were acquired from 25 patients from College of Dental Surgery, Saveetha University who underwent screening for suspected lesions of Oral precancer and Oral cancer along with normal patients who underwent impaction. Biopsies were acquired from the clinically suspicious area and immediately placed in Dulbecco modified eagles growth medium (DMEM). Reflectance confocal images were obtained at multiple image plane depths from biopsies within 6 h of excision. After imaging, biopsies were fixed in 10% formalin and submitted for routine histopathological examination by an experienced oral and maxillofacial pathologist. Reflectance confocal images were compared with histological images from the same sample to determine the tissue features which contribute to early cellular changes, image contrast and early diagnosis.The confocal images were obtained to a depth of up to 150 microns on intact biopsy specimens and subsequent 3-dimensional images, keratin thickness measurements, cell measurements, cell density analysis and graphical representations were performed using Leica image analysis software. In normal mucosa keratin deposition were seen as alternating dark and bright stacks and in different cell layers the nuclei were seen as disks of varying intensities. In pre-cancerous lesions the keratin thickness and cell nuclear density were found to be increased when compared to normal controls. In OSMF cases confocal images of fibrosis show scattering from individual fibres as hyperdense areas. Oral squamous cell carcinoma cases demonstrated extensive variations in cell size, nuclear size and nuclear morphology. At cellular level, dysplastic features like increased nuclear density, increased nuclear cytoplasmic ratio, nuclear and cellular pleomorphism with loss of cohesiveness were identified in all five cases.Our results support the potential of reflectance confocal microscopy to play a significant role in clinical evaluations of oral lesions, early diagnosis of potentially malignant and malignant oral lesions and real time identification of tumour margins. (C) 2010 Elsevier Ltd. All rights reserved.