Pump-probe imaging differentiates melanoma from melanocytic nevi.
Pump-probe imaging differentiates melanoma from melanocytic nevi.
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DOI：
10.1126/scitranslmed.3001604
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发表时间：
2011-02-23
影响因子：
17.1
通讯作者：
Warren WS
中科院分区：
文献类型：
--
作者：
Matthews TE;Piletic IR;Selim MA;Simpson MJ;Warren WS
黑色素瘤诊断在临床上具有挑战性;皮肤科医生目视检查的准确性变化很大，并且严重影响假阳性。即使是目前活检的黄金标准，也会导致病理学家的诊断结果各不相同。我们已经开发了一种多光子技术（基于泵浦探测光谱），直接确定真黑素和褐黑素在人类皮肤色素性病变的微观分布。我们的初步结果显示，非恶性痣和黑色素瘤之间的黑色素化学种类有显著差异，以及一些实质性的结构差异。我们检查了42个色素性病变的切片，发现与非恶性痣相比，黑色素瘤的真黑素含量增加。当用作诊断标准时，真黑素与褐黑素的比率捕获了所有研究的黑色素瘤，但排除了四分之三的发育不良痣和所有良性皮肤痣。评价建筑和细胞学特征揭示了多光子成像，包括黑色素细胞的成熟，存在色素黑色素细胞在真皮中，黑色素细胞巢的数量和位置，并融合色素细胞在表皮中，进一步增加了特异性，允许拒绝超过一半的剩余假阳性结果。然后，我们将这种多光子成像技术应用于苏木精和伊红（H&E）染色的载玻片。通过在H& E染色切片中添加黑色素化学对比，病理学家将获得补充信息，以提高黑色素瘤诊断的轻松性和准确性。
Melanoma diagnosis is clinically challenging; the accuracy of visual inspection by dermatologists is highly variable and heavily weighted toward false positives. Even the current gold standard of biopsy results in varying diagnoses among pathologists. We have developed a multiphoton technique (based on pump-probe spectroscopy) that directly determines the microscopic distribution of eumelanin and pheomelanin in pigmented lesions of human skin. Our initial results showed a marked difference in the chemical variety of melanin between nonmalignant nevi and melanoma, as well as a number of substantial architectural differences. We examined slices from 42 pigmented lesions and found that melanomas had an increased eumelanin content compared to nonmalignant nevi. When used as a diagnostic criterion, the ratio of eumelanin to pheomelanin captured all investigated melanomas but excluded three-quarters of dysplastic nevi and all benign dermal nevi. Evaluating architectural and cytological features revealed by multiphoton imaging, including the maturation of melanocytes, presence of pigmented melanocytes in the dermis, number and location of melanocytic nests, and confluency of pigmented cells in the epidermis, further increased specificity, allowing rejection of more than half of the remaining false-positive results. We then adapted this multiphoton imaging technique to hematoxylin and eosin (H&E)–stained slides. By adding melanin chemical contrast to H&E-stained slides, pathologists will gain complementary information to increase the ease and accuracy of melanoma diagnosis.
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