Department of Urology, University of Modena and Reggio Emilia, Modena, Italy; Urology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Department of Urology, University of Modena and Reggio Emilia, Modena, Italy.
Clin Genitourin Cancer. 2020 Apr;18(2):95-104. doi: 10.1016/j.clgc.2019.07.012. Epub 2019 Jul 19.
Histopathologic examination of the pathologic specimens using hematoxylin & eosin stains represents the backbone of the modern pathology. It is time-consuming; thus, "real-time" assessment of prostatic and periprostatic tissue has gained special interest in the diagnosis and management of prostate cancer. The current study focuses on the review of the different available techniques for "real-time" evaluation of surgical margins during radical prostatectomy (RP). We performed a comprehensive search of the Medline database to identify all the articles discussing "real-time" or intraoperative assessment of surgical margins during RP. Several filters were applied to the search to include only English articles performed on human subjects and published between January 2000 and March 2019. The search revealed several options for pathologic assessment of surgical margins including intraoperative frozen sections, confocal laser endomicroscopy, optical spectroscopy, photodynamic diagnosis, optical coherence tomography, multiphoton microscopy, structured illumination microscopy, 3D augmented reality, and ex vivo fluorescence confocal microscope. Frozen section represents the gold standard technique for real-time pathologic examinations of surgical margins during RP; however, several other options showed promising results in the initial clinical trials, and considering the rapid development in the field of molecular and cellular imaging, some of these options may serve as an alternative to frozen section.
使用苏木精和伊红染色对病理标本进行组织病理学检查是现代病理学的基础。该过程耗时较长，因此，实时评估前列腺和前列腺周围组织在前列腺癌的诊断和治疗中引起了特别关注。本研究重点回顾了在根治性前列腺切除术（RP）中实时评估手术切缘的不同可用技术。我们对 Medline 数据库进行了全面检索，以确定所有讨论在 RP 期间实时或术中评估手术切缘的文章。对搜索应用了几种筛选器，仅包括在人类受试者上进行的、发表于 2000 年 1 月至 2019 年 3 月之间的英文文章。该搜索揭示了几种用于评估手术切缘的病理选择，包括术中冷冻切片、共聚焦激光内窥镜检查、光谱学、光动力诊断、光学相干断层扫描、多光子显微镜、结构照明显微镜、3D 增强现实和离体荧光共聚焦显微镜。冷冻切片是 RP 期间实时检查手术切缘的金标准技术；然而，其他一些选择在初步临床试验中显示出有希望的结果，并且考虑到分子和细胞成像领域的快速发展，其中一些选择可能可以替代冷冻切片。
