Espinasse Marine, Cinotti Elisa, Grivet Damien, Labeille Bruno, Prade Virginie, Douchet Catherine, Cambazard Frédéric, Thuret Gilles, Gain Philippe, Perrot Jean Luc
Department of Ophthalmology, University Hospital of St-Etienne, Saint Etienne, France.
Department of Biology, Engineering and Imaging of Corneal Graft Laboratory, Institute of Research in Sciences and Health Engineering, EA2512, Jean Monnet University, Saint-Etienne, France.
Clin Exp Ophthalmol. 2017 Jul;45(5):442-447. doi: 10.1111/ceo.12904. Epub 2017 Jan 31.
Ex vivo confocal microscopy is a recent imaging technique for the perioperative control of skin tumour margins. Up to date, it has been used in the fluorescence mode and with vertical sections of the specimen margins. The aim of this study was to evaluate its use in the reflectance mode and with a horizontal ('en face') scanning of the surgical specimen in a series of basal cell carcinoma of the eyelid.
Prospective consecutive cohort study was performed at the University Hospital of Saint-Etienne, France.
Forty-one patients with 42 basal cell carcinoma of the eyelid participated in this study.
Basal cell carcinomas were excised with a 2-mm-wide clinically safe margin. The surgical specimens were analysed under ex vivo confocal microscopy in the reflectance mode and with an en face scanning in order to control at a microscopic level if the margins were free from tumour invasion. Histopathogical examination was later performed in order to compare the results.
Sensitivity and specificity of ex vivo confocal microscopy for the presence of tumour-free margins.
Ex vivo confocal microscopy results were consistent with histopathology in all cases (tumour-free margins in 40 out of 42 samples; sensitivity and specificity of 100%).
Ex vivo confocal microscopy in the reflectance mode with an 'en face' scanning can control tumour margins of eyelid basal cell carcinomas and optimize their surgical management. This procedure has the advantage on the fluorescent mode of not needing any contrast agent to examine the samples.
离体共聚焦显微镜检查是一种用于皮肤肿瘤边缘围手术期控制的新型成像技术。迄今为止，它一直用于荧光模式，并对标本边缘进行垂直切片检查。本研究的目的是评估其在反射模式下以及对一系列眼睑基底细胞癌手术标本进行水平（“正面”）扫描时的应用。
在法国圣艾蒂安大学医院进行了前瞻性连续队列研究。
41例患有42个眼睑基底细胞癌的患者参与了本研究。
以2毫米宽的临床安全切缘切除基底细胞癌。对手术标本进行离体共聚焦显微镜反射模式分析和正面扫描，以便在显微镜水平控制边缘是否无肿瘤浸润。随后进行组织病理学检查以比较结果。
离体共聚焦显微镜检查对无肿瘤边缘的敏感性和特异性。
在所有病例中，离体共聚焦显微镜检查结果与组织病理学一致（42个样本中有40个无肿瘤边缘；敏感性和特异性均为100%）。
反射模式下采用“正面”扫描的离体共聚焦显微镜检查可控制眼睑基底细胞癌的肿瘤边缘，并优化其手术管理。该方法相对于荧光模式的优势在于检查样本时无需任何造影剂。
