Use of ex vivo confocal scanning laser microscopy during Mohs surgery for nonmelanoma skin cancers
Use of ex vivo confocal scanning laser microscopy during Mohs surgery for nonmelanoma skin cancers
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DOI：
10.1111/j.1524-4725.2004.30505.x
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发表时间：
2004-12-01
影响因子：
2.4
通讯作者：
Jiang, SB
中科院分区：
文献类型：
--
作者：
Chung, VQ;Dwyer, PJ;Jiang, SB
背景离体共焦扫描激光显微镜提供了快速的光学反射成像切除组织没有传统的冷冻组织病理学，可以潜在地加快莫氏手术。目的是确定在Mohs手术中使用离体共聚焦扫描激光显微镜检测残留基底细胞癌和鳞状细胞癌的可行性。115例I期莫氏手术切除（92例基底细胞癌，23例鳞状细胞癌）采用醋酸增白和共聚焦扫描激光显微镜成像，并与常规莫氏冷冻组织切片进行正常和肿瘤特征比较。通过离体共聚焦扫描激光显微镜很容易检测到残留肿瘤的大聚集体，如结节性基底细胞癌，而较小的肿瘤病灶并不一致。描述了肿瘤亚型的共聚焦形态。离体共聚焦扫描激光显微镜可以潜在地加快莫氏手术，快速检测大结节基底细胞癌，而无需常规冷冻组织病理学。为了使这种新技术在莫氏手术中得到更广泛的应用和接受，有必要进一步改进仪器和图像质量。
BACKGROUND. Ex vivo confocal scanning laser microscopy offers rapid optical reflectance imaging of excised tissue without conventional frozen histopathology that can potentially expedite Mohs surgery.OBJECTIVE. The objective was to determine the feasibility of using ex vivo confocal scanning laser microscopy during Mohs surgery for detecting residual basal cell carcinoma and squamous cell carcinoma.METHODS. One-hundred fifteen Stage I Mohs surgery excisions (92 basal cell carcinoma, 23 squamous cell carcinoma) were imaged with acetowhitening and confocal scanning laser microscopy and compared to conventional Mohs frozen histologic sections for normal and tumor features.RESULTS. Large aggregates of residual tumor such as nodular basal cell carcinoma were easily detected by ex vivo confocal scanning laser microscopy, whereas smaller tumor foci were not consistently identified. Confocal morphology of tumor subtypes is described.CONCLUSION. Ex vivo confocal scanning laser microscopy can potentially expedite Mohs surgery in rapidly detecting large nodular basal cell carcinomas without conventional frozen histopathology. Further improvements in instrumentation and image quality are necessary to allow broader application and acceptance of this novel technology in Mohs surgery.