Panarello Daniele, Compérat Eva, Seyde Olivia, Colau Alexandre, Terrone Carlo, Guillonneau Bertrand
Service of Urology, Diaconesses-Croix St Simon Hospital, Sorbonne University, Paris, France; Department of Urology, San Martino Hospital, Genoa University, Genova, Italy.
Service of Pathology, Tenon Hospital, HUEP, Sorbonne University, Paris, France.
Eur Urol Focus. 2020 Sep 15;6(5):941-958. doi: 10.1016/j.euf.2019.01.004. Epub 2019 Jan 23.
Confocal laser endomicroscopy (CLE) is an optical device that aims to image histological architecture and may be used to reduce positive surgical margins. The ability of CLE to describe prostatic and periprostatic tissues, and prostate cancer (PCa) is still an object of investigation.
To create an atlas of ex vivo CLE images of prostatic and periprostatic tissues, and PCa in order to recognise different prostatic structures.
DESIGN, SETTING, AND PARTICIPANTS: From November 2017 to February 2018, 15 patients underwent radical prostatectomy for biopsy-proven PCa.
Based on preoperative data and macroscopic examination, tumour location was assessed and confirmed on frozen sections. Prior to ex vivo CLE analysis, prostates were stained with fluorescein 10%. We used a GastroFlex probe to collect images of periprostatic tissue (adipose tissue, fibrous and connective tissues, vessels, nerve sheets, seminal vesicles, and urethra). Normal prostatic glands and tumour tissue according to the Gleason grade were analysed. Each PCa Gleason score was represented.
A total of 139 video clips and 237 pictures of prostatic and periprostatic tissues were collected. Among them, we selected 16 highly representative images. Adipose tissue, fibrous tissue, and connective tissue were supposable in all 15 specimens. PCa glands captured fluorescein in their cytoplasm, normal prostatic glands did not capture fluorescein, and glandular structures were easily recognisable. The principal limitation of this study is its ex vivo nature of the study.
Each CLE image was correlated with the corresponding haematoxylin/eosin/saffron definitive pathology image, allowing building of an atlas as a necessary tool to assess the diagnostic performance of CLE during radical prostatectomy in achieving negative surgical margins.
In this study, we aim to provide an atlas of images illustrating prostatic, periprostatic, and PCa tissues obtained using Cellvizio confocal laser endomicroscopy as a tool for further interpretation of intraoperative surgical margins during radical prostatectomy.
共聚焦激光内镜显微镜（CLE）是一种旨在对组织学结构进行成像的光学设备，可用于减少手术切缘阳性。CLE描述前列腺及前列腺周围组织和前列腺癌（PCa）的能力仍是一个研究对象。
创建前列腺及前列腺周围组织和PCa的离体CLE图像图谱，以识别不同的前列腺结构。
设计、设置和参与者：2017年11月至2018年2月，15例经活检证实为PCa的患者接受了根治性前列腺切除术。
根据术前数据和宏观检查评估肿瘤位置，并在冰冻切片上进行确认。在离体CLE分析之前，前列腺用10%的荧光素染色。我们使用GastroFlex探头采集前列腺周围组织（脂肪组织、纤维和结缔组织、血管、神经束、精囊和尿道）的图像。分析了根据Gleason分级的正常前列腺腺体和肿瘤组织。呈现了每个PCa Gleason评分。
共收集了139个视频片段和237张前列腺及前列腺周围组织的图片。其中，我们选择了16张具有高度代表性的图像。在所有15个标本中均可推测出脂肪组织、纤维组织和结缔组织。PCa腺体在其细胞质中捕获荧光素，正常前列腺腺体未捕获荧光素，且腺体结构易于识别。本研究的主要局限性在于其离体研究性质。
每张CLE图像都与相应的苏木精/伊红/番红最终病理图像相关联，从而能够构建一个图谱，作为评估CLE在根治性前列腺切除术中实现阴性手术切缘的诊断性能的必要工具。
在本研究中，我们旨在提供一组图像图谱，展示使用Cellvizio共聚焦激光内镜显微镜获得的前列腺、前列腺周围和PCa组织，作为在根治性前列腺切除术中进一步解释术中手术切缘的工具。
