Sorokina Anastasia, Danilevskaya Olesya, Averyanov Alexander, Zabozlaev Fedor, Sazonov Dmitry, Yarmus Lonny, Lee Hans J
Department of Pathology, Federal Research Clinical Center under FMBA of Russia, Moscow, Russia.
Respirology. 2014 Aug;19(6):907-13. doi: 10.1111/resp.12326. Epub 2014 Jun 9.
Probe-based confocal laser endoscopy (pCLE) allows for real-time non-invasive histological imaging via bronchoscopy. Interpreting CLE images and correlating with traditional histopathology remains challenging. We performed an ex vivo study to evaluate the correlation between light microscopy findings and pCLE imaging of primary lung carcinoma.
Post-lobectomy specimens for lung cancer nodules were examined ex vivo by pCLE. The examined areas were marked with brilliant green dye, and the surrounding tissues were stained by methylene blue dye. Lung tissue segments were resected and histopathological specimens were generated with 50-μm thickness from the marked areas and stained with haematoxylin and eosin. Pathologists and pulmonologists reviewed the images for correlating features.
Eighteen lobectomy specimens from 18 different patients were collected. Three primary features were observed in all samples using pCLE in the cancer surroundings: alveolar dystelectasis with thickening of alveolar walls, alveolar edema and a large amount of macrophages. The stromal and parenchymal components of the studied subtypes of non-small-cell lung cancer differed from each other. The stromal component for all nine adenocarcinoma specimens had a highly fluorescent field penetrated by dark hollows. All six squamous cell carcinoma specimens had the stromal component appeared as 'biparously' branching, highly fluorescent fibres. No stromal component was observed in any small-cell carcinoma specimen, and at low power field, the cellular component was dominant with an observed light scattering pattern.
pCLE can identify lung carcinoma in ex vivo samples. Certain light microscopy features of lung carcinoma can be visualized with pCLE.
基于探头的共聚焦激光内镜检查（pCLE）可通过支气管镜进行实时非侵入性组织学成像。解读共聚焦激光内镜（CLE）图像并与传统组织病理学结果相关联仍具有挑战性。我们进行了一项离体研究，以评估原发性肺癌的光学显微镜检查结果与pCLE成像之间的相关性。
对肺癌结节的肺叶切除术后标本进行离体pCLE检查。检查区域用亮绿染料标记，周围组织用亚甲蓝染料染色。切除肺组织段，从标记区域制作厚度为50μm的组织病理学标本，并用苏木精和伊红染色。病理学家和肺科医生对图像进行审查以寻找相关特征。
收集了来自18例不同患者的18个肺叶切除标本。在癌症周围使用pCLE在所有样本中观察到三个主要特征：肺泡壁增厚伴肺泡萎陷、肺泡水肿和大量巨噬细胞。非小细胞肺癌研究亚型的间质和实质成分彼此不同。所有九个腺癌标本的间质成分都有一个被深色空洞穿透的高荧光区域。所有六个鳞状细胞癌标本的间质成分表现为“双叉状”分支的高荧光纤维。在任何小细胞癌标本中均未观察到间质成分，在低倍视野下，细胞成分占主导，呈现出观察到的光散射模式。
pCLE可在离体样本中识别肺癌。肺癌的某些光学显微镜特征可通过pCLE可视化。
