Department of Otorhinolaryngology, Head and Neck Surgery, University of Rostock, Rostock, Germany.
J Oral Pathol Med. 2010 Apr;39(4):318-27. doi: 10.1111/j.1600-0714.2009.00841.x. Epub 2009 Dec 29.
A rigid confocal endoscope has been developed to assess the oral squamous epithelium of mice and to determine sensitivity, specificity, and accuracy of this new technology.
This endoscope is connected to the commercially available Heidelberg Retina Tomograph (HRT). HRT is a device with a 670-nm diode laser designed to acquire topographical measurements of the optic nerve head. Real-time rigid confocal endoscopy is demonstrated by imaging the epithelial lesions of a mice model. Six-week-old male C57Bl/6 mice were randomly divided into a non-treated group (n = 10) and into a 4-nitroquinoline 1-oxide (4-NQO)-treated group (n = 50). In the 4-NQO-treated group, the mice obtained 4-nitroquinoline 1-oxide in the drinking water (100 microg/ml) to induce tumourigenesis in the mouse tongue. The 4-NQO-solution was diluted in the drinking water for mice. After an 8-16-week carcinogen treatment with 4-NQO (ad libitum), mouse tongues were dissected within 3 h after CO(2) overdose. After confocal microscopy of all lesions of the tongue, conventional histopathological investigation was performed.
The inter-rater reliability for the two observers of the confocal microscopic findings was found to be Kappa = 0.59 (P < 0.001). The penetration depth varied in the healthy tissue of the underside of the tongue throughout this study and was measured between 104 and 240 microm. In keratotic lesions, the penetration depths were diminished and varied between 80 and 140 microm. Strong keratinization inhibits the evaluation of the epithelium. For differentiation between low-grade and high-grade squamous intra-epithelial lesions, a sensitivity and specificity of 73% and 88% was reached.
The animal experiment with this non-invasive new technology indicates that this imaging technology facilitates the detection of pre-cancerous lesions of the underside of the oropharynx. Human studies on oropharyngeal and laryngeal lesions are needed to prove the applicability of this method in the field of otorhinolaryngology.
为了评估小鼠口腔鳞状上皮，我们开发了一种刚性共聚焦内窥镜，并确定了这项新技术的灵敏度、特异性和准确性。
该内窥镜与市售的海德堡视网膜断层扫描仪（HRT）相连。HRT 是一种带有 670nm 激光二极管的设备，旨在获取视神经头的地形测量值。通过对小鼠模型上皮病变的成像，展示实时刚性共聚焦内窥镜。6 周龄雄性 C57Bl/6 小鼠随机分为未处理组（n = 10）和 4-硝基喹啉 1-氧化物（4-NQO）处理组（n = 50）。在 4-NQO 处理组中，小鼠饮用含 4-NQO（100μg/ml）的水以诱导舌肿瘤发生。4-NQO 溶液在水中稀释供小鼠饮用。经 4-NQO（自由饮用）8-16 周致癌处理后，CO2 过量后 3 小时内解剖小鼠舌。对所有舌病变进行共聚焦显微镜检查后，进行常规组织病理学检查。
两位观察者对共聚焦显微镜检查结果的组内一致性发现 Kappa = 0.59（P < 0.001）。在整个研究过程中，舌下健康组织的穿透深度各不相同，测量值在 104 至 240μm 之间。在角化病变中，穿透深度减小，在 80 至 140μm 之间。强烈的角化会抑制上皮的评估。对于低级别和高级别鳞状上皮内病变的鉴别，灵敏度和特异性分别为 73%和 88%。
这项针对该非侵入性新技术的动物实验表明，这种成像技术有助于发现口咽下部的癌前病变。需要对口咽和喉病变进行人体研究，以证明该方法在耳鼻喉科领域的适用性。
