Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany.
Int J Dermatol. 2021 Feb;60(2):236-240. doi: 10.1111/ijd.15152. Epub 2020 Dec 23.
Real-time microscopic imaging of freshly excised oral squamous cell carcinomas (OSCCs) would be potentially supportive in rapid recognition of oral malignancy and an optimal and time-saving management of patients' surgical treatment.
The aim of this study was to examine oral squamous cell cancer tissue in regards to the commonly known and well-described histomorphologic criteria for the diagnosis of OSCC in ex vivo confocal fluorescent microscopy and to analyze its correlation with grade of differentiation and level of invasiveness.
Ex vivo confocal laser scanning microscopy (CLSM) images of 38 OSCCs were evaluated immediately after excision for presence or absence of various cytological and architectural features based on the histopathological background. Next, these features were compared to the grade of differentiation as elaborated via gold standard histologic examination.
Of 38 invasive OSCCs, 14 were well differentiated, while three moderately and 19 were poorly differentiated. The presence of the commonly known cytologic and histopathologic criteria for the diagnosis of oral squamous cell carcinoma such as the destruction of the basal cell membrane, cellular and nuclear pleomorphism, anisocytosis, intraepithelial keratinization, nuclear hyperchromasia, atypical mitotic figures as well as the presence of necrosis, and mixed inflammation could be observed in ex vivo fluorescence confocal microscopy (FCM). In ex vivo fluorescence confocal microscopy pictures, cellular pleomorphism and anisocytosis were observed more often in poorly differentiated OSCCs. Intraepithelial keratinization was associated with well differentiated and moderately differentiated OSCCs.
The results demonstrate the high potential of ex vivo fluorescence confocal microscopy in fresh tissue for rapid real-time diagnosis of OSCC.
实时微观成像的新鲜切除的口腔鳞状细胞癌（OSCCs）将有可能支持在快速识别口腔恶性和最佳的时间节省患者的手术治疗。
本研究的目的是检查口腔鳞状细胞癌组织中常见的和描述的组织形态学标准诊断为 OSCC 在体外共聚焦荧光显微镜，并分析其与分化程度和浸润水平的相关性。
38 例 OSCC 切除后立即进行离体共聚焦激光扫描显微镜（CLSM）检查，根据组织病理学背景，观察有无各种细胞学和结构特征。接下来，将这些特征与通过金标准组织学检查详细阐述的分化程度进行比较。
在 38 例侵袭性 OSCC 中，14 例为高分化，3 例为中分化，19 例为低分化。在离体荧光共聚焦显微镜（FCM）中可以观察到常用于诊断口腔鳞状细胞癌的常见细胞学和组织病理学标准，如基底细胞膜破坏、细胞和核多形性、大小不均、上皮内角化、核深染、非典型有丝分裂象以及坏死和混合性炎症的存在。在离体荧光共聚焦显微镜图片中，低分化 OSCC 中观察到更多的细胞多形性和大小不均。上皮内角化与中高分化 OSCC 相关。
结果表明，离体荧光共聚焦显微镜在新鲜组织中对 OSCC 的快速实时诊断具有很高的潜力。
