Toward a Multimodal Cell Analysis of Brush Biopsies for the Early Detection of Oral Cancer
Toward a Multimodal Cell Analysis of Brush Biopsies for the Early Detection of Oral Cancer
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DOI：
10.1002/cncy.20028
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发表时间：
2009-06-25
影响因子：
3.4
通讯作者：
Boecking, Alfred
中科院分区：
文献类型：
--
作者：
Remmerbach, Torsten W.;Meyer-Ebrecht, Dietrich;Boecking, Alfred
背景技术背景：本报告描述了作者所知的半自动多模式细胞分析（MMCA）的首次临床应用，MMCA是一种用于早期检测可疑细胞数量有限的癌症病例的新技术。在这项临床研究中，MMCA应用于口腔癌刷检活检诊断。MMCA方法是基于连续应用相同的、基于载玻片的细胞的多次染色以及重复的重新定位和测量其诊断特征，从而产生单个细胞的多参数特征。不同染色细胞的数据整合提高了诊断准确性。MMCA的实现还实现了全自动的自适应图像预处理，包括多模态图像的配准和细胞核的分割。方法：在一项初步的临床试验中，对47例可疑口腔病变刷检切片进行了分析。最终的组织学诊断包括20例鳞状细胞癌，7例过度角化性白斑，20例粘膜扁平苔藓。研究结果：2个额外的方法（形态学，DNA含量，嗜银核仁组成区计数）的逐步应用增加了常规细胞学诊断的特异性从92.6%到100%。该可行性研究提供了概念验证，证明了基于载玻片的细胞学标本的有效性、稳健性和诊断准确性。结论：作者得出结论，MMCA可能成为一种敏感、高度特异、客观和可重复的辅助诊断工具，用于识别仅含有少量异常细胞的口腔涂片中的肿瘤变化。癌症（癌症细胞病理学）2009;117：228-35。(C)2009年美国癌症协会。
BACKGROUND: This report describes what to the authors' knowledge is the first clinical application of semiautomated multimodal cell analysis (MMCA), a novel technique for the early detection of cancer for cases with a limited number of suspicious cells. In this clinical study, MMCA was applied to oral cancer diagnostics on brush biopsies. The MMCA approach was based on the sequential application of multiple stainings of identical, slide-based cells and repeated relocalizations and measurements of their diagnostic features, resulting in multiparametric features of individual cells. Data integration of the variously stained cells increased diagnostic accuracy. The implementation of MMCA also enabled fully automatic, adaptive image preprocessing, including registration of multimodal images and segmentation of cell nuclei. METHODS: In a preliminary clinical trial, 47 slides from brush biopsies of suspicious oral lesions were analyzed. The final histologic diagnoses included 20 squamous cell carcinomas, 7 hyperkeratotic leukoplakias, and 20 lichen planus mucosae. RESULTS: The stepwise application of 2 additional approaches (morphology, DNA content, argyrophilic nucleolar organizer region counts) increased the specificity of conventional cytologic diagnosis from 92.6% to 100%. This feasibility study provided a proof of concept, demonstrating efficiency, robustness, and diagnostic accuracy on slide-based cytologic specimens. CONCLUSIONS: The authors concluded that MMCA may become a sensitive and highly specific, objective, and reproducible adjuvant diagnostic tool for the identification of neoplastic changes in oral smears that contain only a few abnormal cells. Cancer (Cancer Cytopathol) 2009;117:228-35. (C) 2009 American Cancer Society.