Porphyria and Rare Diseases Unit, San Gallicano Dermatological Institute - IRCCS, Rome, Italy.
Dermatology Service, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
Exp Dermatol. 2023 May;32(5):648-659. doi: 10.1111/exd.14758. Epub 2023 Mar 20.
In vivo reflectance confocal microscopy (RCM) is poorly investigated in oral pathology due to the peculiar anatomical and topographical oral mucosa features. A dedicated handheld confocal microscope with an intra-oral probe was developed for oral mucosa imaging. The main objective was to describe the healthy oral mucosa and the cytoarchitectural findings detectable in different oral disorders by means of the newly designed handheld confocal microscope. Secondary aim was to identify the main RCM criteria that differentiate oral lesions in order to provide algorithm for a rapid non-invasive evaluation. This observational retrospective study included all consecutive patients with oral disorders and volunteers with healthy oral mucosa who underwent RCM examination in our outpatient clinic from September 2018 to December 2021. Three different investigators examined together the RCM images to detect the key features and secondary criteria for each type of oral lesion collected. The study population included 110 patients affected by oral lesions and seven volunteers with healthy oral mucosae. A total of 15 oral disorders were imaged and divided in three main groups: white, red and pigmented lesions. Key features and secondary criteria were identified for every single type of oral disease. RCM permits a cytoarchitectural evaluation of the oral mucosae affected by inflammatory, dysplastic and neoplastic diseases, thus orienting the clinicians towards non-invasive diagnosis and enhancing the diagnostic management. The "tree diagrams" proposed allow a schematic and simplified view of confocal features for each type of oral disease, thus drastically reducing the diagnostic timing.
体内反射共聚焦显微镜（RCM）在口腔病理学中的研究较少，这是由于口腔黏膜具有特殊的解剖学和地形学特征。一种专门用于口腔黏膜成像的手持式共聚焦显微镜和口腔内探头已经被开发出来。主要目的是通过新设计的手持式共聚焦显微镜描述健康的口腔黏膜和可检测到的不同口腔疾病的细胞结构特征。次要目的是确定区分口腔病变的主要 RCM 标准，以便为快速非侵入性评估提供算法。这项观察性回顾性研究包括所有在我们的门诊接受 RCM 检查的患有口腔疾病的连续患者和具有健康口腔黏膜的志愿者。三位不同的研究者一起检查 RCM 图像，以检测收集到的每种口腔病变的主要特征和次要标准。研究人群包括 110 名患有口腔病变的患者和 7 名具有健康口腔黏膜的志愿者。共对 15 种口腔疾病进行了成像，并分为三个主要组：白色、红色和色素性病变。为每种口腔疾病都确定了主要特征和次要标准。RCM 允许对炎症性、发育不良和肿瘤性疾病所累及的口腔黏膜进行细胞结构评估，从而指导临床医生进行非侵入性诊断，并增强诊断管理。所提出的“树状图”允许对每种口腔疾病的共聚焦特征进行示意和简化，从而大大缩短诊断时间。
