Confocal microscopy for real-time detection of oral cavity neoplasia.
Confocal microscopy for real-time detection of oral cavity neoplasia.
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发表时间：
2003-10
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通讯作者：
A. Clark;A. Gillenwater;T. Collier;R. Alizadeh‐Naderi;A. El-Naggar;R. Richards-Kortum
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作者：
A. Clark;A. Gillenwater;T. Collier;R. Alizadeh‐Naderi;A. El-Naggar;R. Richards-Kortum
本研究的目的是使用反射共聚焦显微镜来表征正常和肿瘤性口腔粘膜的特征。实验设计口腔活组织检查取自德克萨斯大学M。D.安德森癌症中心，他们正在接受口腔鳞状细胞癌手术。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，并进行常规组织学检查。将反射共聚焦图像与来自相同样品的组织学图像进行比较，以确定哪些组织特征有助于图像对比度，并且可以使用体内共聚焦显微镜进行成像。结果共聚焦图像成功地获得了17例患者的15个活检对。在口腔内的多个解剖部位观察到细胞直径和核密度的深度相关变化。在鳞状细胞癌中，密集的，多形性的肿瘤细胞核可以被可视化，在肿瘤性和非肿瘤性口腔的共聚焦图像之间的核密度和形态的明显差异可区分。在共焦图像中可以识别的非癌性和癌性口腔组织的其他特征包括炎症、纤维化、肌纤维和唾液腺区域。结论：我们的研究结果支持该工具在口腔病变的临床评价、肿瘤边缘的实时识别和治疗反应的监测中发挥重要作用的潜力。
PURPOSE The goal of this study was to characterize features of normal and neoplastic oral mucosa using reflectance confocal microscopy. EXPERIMENTAL DESIGN Oral cavity biopsies were acquired from 17 patients at the Head and Neck Clinic of The University of Texas M. D. Anderson Cancer Center who were undergoing surgery for squamous cell carcinoma within the oral cavity. 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 histological examination. Reflectance confocal images were compared with histological images from the same sample to determine which tissue features contribute to image contrast and can be potentially imaged using in vivo confocal microscopy. RESULTS Confocal images were successfully acquired from 15 biopsy pairs from 17 patients. Depth-related changes in cell diameter and nuclear density were observed at multiple anatomical sites within the oral cavity. In squamous cell carcinomas, densely packed, pleomorphic tumor nuclei could be visualized with distinct differences in nuclear density and morphology distinguishable between confocal images of neoplastic and nonneoplastic oral cavity. Other features of noncancerous and cancerous oral tissue that could be identified in the confocal images included areas of inflammation, fibrosis, muscle fibers, and salivary glands. CONCLUSIONS Our results support the potential for this tool to play a significant role in the clinical evaluation of oral lesions, real-time identification of tumor margins, and monitoring of response to therapeutic treatment.