Confocal fluorescence microscopy for rapid evaluation of invasive tumor cellularity of inflammatory breast carcinoma core needle biopsies
Confocal fluorescence microscopy for rapid evaluation of invasive tumor cellularity of inflammatory breast carcinoma core needle biopsies
复制标题
DOI：
10.1007/s10549-014-3182-5
复制
发表时间：
2015-01-01
影响因子：
3.8
通讯作者：
Richards-Kortum, Rebecca
中科院分区：
文献类型：
--
作者：
Dobbs, Jessica;Krishnamurthy, Savitri;Richards-Kortum, Rebecca
对于炎性乳腺癌，组织取样是一个棘手的问题，需要在芯针活检后立即进行评估，以评估标本的充分性。我们试图确定共聚焦荧光显微镜是否提供了足够的分辨率，以评估标本充分性，通过比较标准组织学图像估计的侵袭性肿瘤细胞的共聚焦图像乳腺芯针活检标本估计的侵袭性肿瘤细胞。乳腺芯针活检标本的灰度共聚焦荧光图像后获得的proflavine应用。乳腺专用病理学家评价了苏木精和伊红染色的组织学图像以及核心的灰度和假彩色共聚焦图像中的侵袭性肿瘤细胞构成。使用kappa系数定量细胞构成估计值之间的一致性。对23例疑似炎性乳腺癌患者的23个核心进行了成像。共聚焦图像的采集时间平均小于2分钟/核心。根据组织学和灰度共聚焦图像估计的侵袭性肿瘤细胞构成显示出中等一致性，kappa系数为：kappa = 0.48 +/- A 0.09（p < 0.001）。灰度共聚焦图像需要不到2分钟的采集，并允许评估乳腺空芯针活检标本中的浸润性肿瘤细胞结构，与组织学图像中度一致。我们发现，共聚焦荧光显微镜可以立即进行标本采集后，并可能表明需要额外的活检在首次访问。
Tissue sampling is a problematic issue for inflammatory breast carcinoma, and immediate evaluation following core needle biopsy is needed to evaluate specimen adequacy. We sought to determine if confocal fluorescence microscopy provides sufficient resolution to evaluate specimen adequacy by comparing invasive tumor cellularity estimated from standard histologic images to invasive tumor cellularity estimated from confocal images of breast core needle biopsy specimens. Grayscale confocal fluorescence images of breast core needle biopsy specimens were acquired following proflavine application. A breast-dedicated pathologist evaluated invasive tumor cellularity in histologic images with hematoxylin and eosin staining and in grayscale and false-colored confocal images of cores. Agreement between cellularity estimates was quantified using a kappa coefficient. 23 cores from 23 patients with suspected inflammatory breast carcinoma were imaged. Confocal images were acquired in an average of less than 2 min per core. Invasive tumor cellularity estimated from histologic and grayscale confocal images showed moderate agreement by kappa coefficient: kappa = 0.48 +/- A 0.09 (p < 0.001). Grayscale confocal images require less than 2 min for acquisition and allow for evaluation of invasive tumor cellularity in breast core needle biopsy specimens with moderate agreement to histologic images. We show that confocal fluorescence microscopy can be performed immediately following specimen acquisition and could indicate the need for additional biopsies at the initial visit.