Multiphoton microscopy in the evaluation of human bladder biopsies.
Multiphoton microscopy in the evaluation of human bladder biopsies.
复制标题
多光子显微镜在评估人膀胱活检时。
DOI：
10.5858/arpa.2011-0147-oa
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发表时间：
2012-05
影响因子：
4.6
通讯作者：
Mukherjee S
中科院分区：
文献类型：
--
作者：
Jain M;Robinson BD;Scherr DS;Sterling J;Lee MM;Wysock J;Rubin MA;Maxfield FR;Zipfel WR;Webb WW;Mukherjee S
多光子显微镜(MPM)是一种非线性成像方法，通过激发组织的固有辐射来提供新鲜(未处理)组织的细胞和亚细胞细节。随着微型化和成本的大幅降低，MPM是一种新兴的体内成像技术，具有许多潜在的临床应用前景。目的：评价MPM对人膀胱活检的成像能力和诊断准确性。77例新鲜膀胱活检组织被MPM成像，随后提交常规外科病理诊断。排除了12例，因为广泛的烧灼伪影妨碍了确诊。将MPM图像与金标准苏木精-伊红(H&E)染色切片进行比较。在57/65例(88%)，MPM的诊断(良性或肿瘤性)是基于结构和/或细胞学分级。本研究中MPM的敏感性和特异性分别为90.4%和76.9%。MPM的阳性(肿瘤性)诊断具有很高的预测价值(94%)，三分之二的病例组织病理学支持阴性(良性)诊断。56/65例(86%)正确判断乳头状结构与扁平结构，38/56例(68%)正确判断细胞学分级(良性/低/高级别)。仅MPM图像就能提供足够的细节，使用与组织病理学相同的基本诊断标准(结构和细胞学分级)将大多数病变分类为良性或肿瘤性。未来MPM技术的发展可能会为泌尿科医生和病理学家提供更多的筛查和诊断工具，以早期发现膀胱癌。这些新兴技术的更多应用值得探索。
Multiphoton microscopy (MPM) is a nonlinear imaging approach, providing cellular and subcellular details from fresh (unprocessed) tissue by exciting intrinsic tissue emissions. With miniaturization and substantially decreased cost on the horizon, MPM is an emerging in vivo imaging technique with many potential clinical applications. To assess the imaging ability and diagnostic accuracy of MPM for human bladder biopsies. Seventy-seven fresh bladder biopsies were imaged by MPM and subsequently submitted for routine surgical pathology diagnosis. Twelve cases were excluded due to extensive cautery artifact that prohibited definitive diagnosis. Comparison was made between MPM imaging and gold standard hematoxylin and eosin (H&E) stained sections of each specimen. In 57/65 cases (88%), accurate MPM diagnoses (benign or neoplastic) were given based upon the architecture and/or cytologic grade. The sensitivity and specificity of MPM in our study were 90.4% and 76.9%, respectively. A positive (neoplastic) diagnosis on MPM had a high predictive value (94%), and negative (benign) diagnoses were sustained on histopathology in two-thirds of cases. Architecture (papillary vs. flat) was correctly determined in 56/65 cases (86%), and cytologic grade (benign/low vs. high grade) was assigned correctly in 38/56 cases (68%). MPM images alone provide sufficient detail to classify most lesions as either benign or neoplastic using the same basic diagnostic criteria as histopathology (architecture and cytologic grade). Future developments in MPM technology may provide urologists and pathologists with additional screening and diagnostic tools for early detection of bladder cancer. Additional applications of such emerging technologies warrant exploration.