Multiresolution nondestructive 3D pathology of whole lymph nodes for breast cancer staging.
Multiresolution nondestructive 3D pathology of whole lymph nodes for breast cancer staging.
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DOI：
10.1117/1.jbo.27.3.036501
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发表时间：
2022-03
影响因子：
3.5
通讯作者：
Liu JTC
中科院分区：
文献类型：
--
作者：
Barner LA;Glaser AK;Mao C;Susaki EA;Vaughan JC;Dintzis SM;Liu JTC
对于乳腺癌患者，局部淋巴结（LN）转移的程度影响是否切除所有腋窝淋巴结。目前，转移瘤的识别和分类是通过传统组织学的一些薄组织切片的视觉分析，这可能不足以代表转移的程度。我们试图实现人类腋窝淋巴结的非破坏性三维（3D）病理，并利用我们的方法开发淋巴结分期的实用工作流程。我们还试图评估与二维（2D）组织学相比，3D病理学是否能提高分期准确性。我们开发了一种荧光染色和光学透明LN标本的方法，用于多分辨率开顶光片显微镜的全面成像。我们提出了一种高效的成像和数据处理工作流程，用于快速评估h&e样数据集的3D，通过低分辨率筛选识别潜在的转移，然后通过高分辨率局部成像确认恶性肿瘤。我们用来自10个转移淋巴结的3D和2D病理数据集模拟LN分期，结果显示2D病理总是低估转移的大小，包括3D病理会导致转移的高分期的情况，这对临床治疗具有重要意义。我们的3D病理学方法可以通过提高淋巴结转移的分期准确性来改善乳腺癌患者的临床管理。
For breast cancer patients, the extent of regional lymph node (LN) metastasis influences the decision to remove all axillary LNs. Metastases are currently identified and classified with visual analysis of a few thin tissue sections with conventional histology that may underrepresent the extent of metastases. We sought to enable nondestructive three-dimensional (3D) pathology of human axillary LNs and to develop a practical workflow for LN staging with our method. We also sought to evaluate whether 3D pathology improves staging accuracy in comparison to two-dimensional (2D) histology. We developed a method to fluorescently stain and optically clear LN specimens for comprehensive imaging with multiresolution open-top light-sheet microscopy. We present an efficient imaging and data-processing workflow for rapid evaluation of H&E-like datasets in 3D, with low-resolution screening to identify potential metastases followed by high-resolution localized imaging to confirm malignancy. We simulate LN staging with 3D and 2D pathology datasets from 10 metastatic nodes, showing that 2D pathology consistently underestimates metastasis size, including instances in which 3D pathology would lead to upstaging of the metastasis with important implications on clinical treatment. Our 3D pathology method may improve clinical management for breast cancer patients by improving staging accuracy of LN metastases.