Department of Pathology, University of Rochester Medical Center, Rochester, NY.
Department Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY.
J Low Genit Tract Dis. 2021 Apr 1;25(2):137-141. doi: 10.1097/LGT.0000000000000590.
Histopathology is the criterion standard for evaluating cervical squamous intraepithelial neoplasia (dysplasia). In this pilot feasibility study, we examined whether a novel 3-dimensional imaging device using Gabor-domain optical coherence microscopy (GDOCM) could distinguish features of cervical dysplasia comparable with histopathology.
A prospective observational pilot study enrolled a small sample of women undergoing loop electrosurgical excision procedure for cervical squamous intraepithelial neoplasia. Fresh ex vivo specimens were imaged with the GDOCM device. Digital images were reviewed by a pathologist who was blinded to the histopathology results. Histopathologic features were then compared with the digital observations.
Standard histologic features of cervical squamous epithelium and of squamous intraepithelial neoplasia could be observed in GDOCM images. Cervical epithelium, stroma, basement membrane, and squamous papilla could all be identified. Human papillomavirus effects, such as vacuolization and cellular density, were also observed.
A GDOCM imaging system has the potential to obtain histologic resolution images of the cervix in the evaluation of squamous intraepithelial neoplasia. This pilot study allowed for optimizing the imaging system and paved the way for a future diagnostic accuracy study. The development of this technology could streamline the evaluation of patients at risk for cervical neoplasia.
组织病理学是评估宫颈鳞状上皮内瘤变(异型增生)的金标准。在这项初步可行性研究中,我们研究了一种新型的基于 Gabor 域光学相干显微镜(GDOCM)的三维成像设备是否能够与组织病理学相比区分宫颈异型增生的特征。
一项前瞻性观察性初步研究纳入了一小部分因宫颈鳞状上皮内瘤变而行环形电切术的女性患者。使用 GDOCM 设备对新鲜离体标本进行成像。由一位对组织病理学结果不知情的病理学家对数字图像进行评估。然后将组织病理学特征与数字观察结果进行比较。
在 GDOCM 图像中可以观察到宫颈鳞状上皮和鳞状上皮内瘤变的标准组织学特征。可以识别宫颈上皮、基质、基底膜和鳞状乳头。还观察到了人乳头瘤病毒的影响,如空泡化和细胞密度。
GDOCM 成像系统具有获得宫颈鳞状上皮内瘤变评估中组织学分辨率图像的潜力。这项初步研究优化了成像系统,为未来的诊断准确性研究铺平了道路。该技术的发展可以简化对宫颈癌风险患者的评估。