State Key Laboratory of Surface Physics and Department of Physics, Human Phenome Institute, Academy for Engineering and Technology, Key Laboratory of Micro and Nano Photonic Structures (Ministry of Education), Fudan University, Shanghai 200433, China.
Department of Pancreatic Surgery, Department of Neurosurgery, Department of Pathology, Huashan Hospital, Fudan University, Shanghai 200040, China.
Anal Chem. 2021 Nov 23;93(46):15550-15558. doi: 10.1021/acs.analchem.1c03861. Epub 2021 Nov 9.
Surgeries achieving maximal tumor resection remain the major effective treatment of pancreatic cancer. Rapid and precise intraoperative diagnosis of pancreatic tissues is critical for optimum surgical outcomes but is challenging for the current staining-based histological methods. We demonstrated that label-free coherent nonlinear optical microscopy with combined stimulated Raman scattering (SRS) and second harmonic generation (SHG) could reveal key diagnostic features of both normal and cancerous human pancreatic tissues. Adjacent pairs of tissue sections from resection margins of 37 patients were imaged by SRS and hematoxylin and eosin staining for direct comparison, demonstrating high diagnostic concordance (Cohen's kappa, κ > 0.97) between them. Fresh unprocessed tissues showed well-preserved histoarchitectures including pancreatic ducts, islets, acini, and nerves. Moreover, the area ratios of collagen fibers were analyzed and found to correlate with the drainage pancreatic amylase level (odds ratio = 28.0, = 0.0017). Our results indicated that SRS/SHG histology provides potential for rapid intraoperative diagnosis of pancreatic cancer as well as a predictive value of postoperative pancreatic fistula.
最大限度地切除肿瘤的手术仍然是治疗胰腺癌的主要有效方法。快速准确的术中胰腺组织诊断对于获得最佳手术效果至关重要，但目前基于染色的组织学方法具有挑战性。我们证明，无标记相干非线性光学显微镜结合受激拉曼散射（SRS）和二次谐波产生（SHG）可以揭示正常和癌变人胰腺组织的关键诊断特征。对 37 例患者的切除边缘的相邻组织切片进行 SRS 和苏木精-伊红染色成像，直接比较，显示出它们之间的高诊断一致性（Cohen's kappa，κ＞0.97）。新鲜的未加工组织显示出良好保存的组织形态结构，包括胰腺导管、胰岛、腺泡和神经。此外，还分析了胶原纤维的面积比，并发现其与引流胰淀粉酶水平相关（比值比=28.0，=0.0017）。我们的结果表明，SRS/SHG 组织学为快速术中诊断胰腺癌以及预测术后胰瘘提供了可能。
