Paoli John, Smedh Maria, Ericson Marica B
Dermatology and Venereology Clinic, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Semin Cutan Med Surg. 2009 Sep;28(3):190-5. doi: 10.1016/j.sder.2009.06.007.
The increasing incidence of skin cancer and the importance of early diagnosis is a challenge, which requires the development of reliable, cost-effective, noninvasive, diagnostic techniques. Several such methods based on optical imaging techniques are available and currently being investigated. A novel method in this field is multiphoton laser scanning microscopy (MPLSM). This technique is based on the nonlinear process of 2-photon excitation of endogenous fluorophores, which can be used to acquire horizontal optical sectioning of intact biological tissue samples. When studying human skin, MPLSM provides high-resolution fluorescence imaging, allowing visualization of cellular and subcellular structures of the epidermis and upper dermis. This review covers the application of MPLSM as a diagnostic tool for superficial skin cancers, such as basal cell carcinomas, squamous cell carcinoma in situ, and melanomas. MPLSM has also been applied in other research areas related to skin, which will be mentioned briefly. The morphologic features observed in MPLSM images of skin tumors are comparable to traditional histopathology. Safety issues, limitations, and further improvements are discussed. Although further investigations are required to make MPLSM a mainstream clinical diagnostic tool, MPLSM has the potential of becoming a noninvasive, bedside, histopathologic technique for the diagnosis of superficial skin cancers.
皮肤癌发病率的不断上升以及早期诊断的重要性是一项挑战，这需要开发可靠、经济高效、非侵入性的诊断技术。目前有几种基于光学成像技术的此类方法可供使用并正在进行研究。该领域的一种新方法是多光子激光扫描显微镜（MPLSM）。这项技术基于内源性荧光团的双光子激发的非线性过程，可用于获取完整生物组织样本的水平光学切片。在研究人体皮肤时，MPLSM可提供高分辨率荧光成像，能够观察到表皮和真皮上层的细胞及亚细胞结构。本综述涵盖了MPLSM作为浅表皮肤癌（如基底细胞癌、原位鳞状细胞癌和黑色素瘤）诊断工具的应用。MPLSM还应用于与皮肤相关的其他研究领域，将简要提及。在皮肤肿瘤的MPLSM图像中观察到的形态学特征与传统组织病理学相当。文中还讨论了安全性问题、局限性及进一步改进。尽管需要进一步研究以使MPLSM成为主流临床诊断工具，但MPLSM有潜力成为一种用于诊断浅表皮肤癌的非侵入性床边组织病理学技术。
