Strasswimmer John, Pierce Mark C, Park B Hyle, Neel Victor, de Boer Johannes F
Wellman Center of Photomedicine, Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Blossom Street, Boston, Massachusetts 02114, USA.
J Biomed Opt. 2004 Mar-Apr;9(2):292-8. doi: 10.1117/1.1644118.
Skin cancer is the most common human malignancy, with basal cell carcinoma (BCC) the most frequent type. Aggressive forms of BCC are associated with extensive dermal invasion and destruction of collagen. Surgery is the most common treatment, but identification of tumor borders is a challenge. Polarization-sensitive optical coherence tomography (PS-OCT) is an optical method to examine collagen birefringence. To date, it has not been exploited for cancer management. As part of a pilot exploratory study to examine the use of OCT in skin cancer, we examined several tumors that pose a challenge to the surgeon due to their large size and histological subtype. In normal perilesional skin, OCT identifies epidermal and dermal structure; PS-OCT identified dermal birefringence. In BCC, tumors lost normal structure and gained the appearance of lobular impressions. PS-OCT identified an alteration of dermal birefringence. Examination of a border area revealed a gradual transition from more normal appearing image to frank tumor. These results indicate that PS-OCT can identify features that distinguish normal skin from tumor and may have the potential to guide surgeons in the treatment of aggressive skin cancer.
皮肤癌是人类最常见的恶性肿瘤，其中基底细胞癌（BCC）最为常见。侵袭性BCC与广泛的真皮浸润和胶原蛋白破坏有关。手术是最常见的治疗方法，但确定肿瘤边界是一项挑战。偏振敏感光学相干断层扫描（PS-OCT）是一种检测胶原蛋白双折射的光学方法。迄今为止，它尚未用于癌症治疗。作为一项研究OCT在皮肤癌中应用的探索性试点研究的一部分，我们检查了几例因体积大及组织学亚型而给外科医生带来挑战的肿瘤。在正常的病变周围皮肤中，OCT可识别表皮和真皮结构；PS-OCT可识别真皮双折射。在BCC中，肿瘤失去了正常结构，并呈现出小叶状外观。PS-OCT可识别真皮双折射的改变。对边界区域的检查显示，从外观较正常的图像到明显的肿瘤有一个逐渐过渡的过程。这些结果表明，PS-OCT可以识别区分正常皮肤和肿瘤的特征，并且可能有潜力在侵袭性皮肤癌的治疗中指导外科医生。
