离体荧光共聚焦显微镜在前列腺诊断性活检评估中的诊断性能
Diagnostic Performance of Ex Vivo Fluorescence Confocal Microscopy in the Assessment of Diagnostic Biopsies of the Prostate.
作者信息
Titze Ulf, Hansen Torsten, Brochhausen Christoph, Titze Barbara, Schulz Birte, Gunnemann Alfons, Rocco Bernardo, Sievert Karl-Dietrich
机构信息
Institute of Pathology, University Hospital OWL of the University of Bielefeld, Campus Lippe, 32756 Detmold, Germany.
Institute of Pathology, University of Regensburg, 93053 Regensburg, Germany.
出版信息
Cancers (Basel). 2021 Nov 13;13(22):5685. doi: 10.3390/cancers13225685.
BACKGROUND
Fluorescence confocal microscopy (FCM) is a novel micro-imaging technique providing optical sections of examined tissue. The method has been well established for the diagnosis of tumors in dermatological specimens.
METHODS
We compare intraoperative diagnoses of the real-time application of FCM in pre-therapeutic prostate biopsies (35 patients, total number of biopsy specimens: n = 438) with the findings of conventional histology.
RESULTS
Prostate carcinoma was reliably diagnosed in all patients. Depending on scan quality and experience of the examiner, smaller lesions of well differentiated carcinoma (ISUP1) could not be consistently differentiated from reactive changes. Furthermore, in some cases there was difficulty to distinguish ISUP grade 2 from ISUP grade 1 tumors. ISUP grades 3-5 were reliably detected in FCM.
CONCLUSIONS
Despite some limitations, FCM seems to be an effective tool for the timely assessment of prostate biopsies enabling reliable diagnosis of prostate cancer in patients requiring therapy.
背景
荧光共聚焦显微镜（FCM）是一种新型显微成像技术，可提供被检查组织的光学切片。该方法在皮肤病标本肿瘤诊断中已得到充分确立。
方法
我们将FCM在治疗前前列腺活检（35例患者，活检标本总数：n = 438）中的实时应用的术中诊断结果与传统组织学检查结果进行比较。
结果
所有患者均被可靠诊断为前列腺癌。根据扫描质量和检查者经验，高分化癌（ISUP1）的较小病变无法始终与反应性改变区分开来。此外，在某些情况下，难以将ISUP 2级肿瘤与ISUP 1级肿瘤区分开来。FCM能够可靠地检测到ISUP 3 - 5级肿瘤。
结论
尽管存在一些局限性，但FCM似乎是及时评估前列腺活检的有效工具，能够对需要治疗的患者进行可靠的前列腺癌诊断。
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