Liu Min, Lu Jianqiao, Zhi Yong, Ruan Yetian, Cao Guangxu, Xu Xinxin, An Xin, Gao Jinli, Li Fang
Department of Obstetrics and Gynecology, Shanghai East Hospital, School of Medicine, Tongji University, 150 Jimo Road, Shanghai, 200120, China.
OptoMedic Technologies Inc., Foshan, 528200, China.
Infect Agent Cancer. 2023 Apr 26;18(1):26. doi: 10.1186/s13027-023-00498-8.
Cervical cancer is an important public health problem. Conventional colposcopy is inefficient in the diagnosis of cervical lesions and massive biopsies result in trauma. There is an urgent need for a new clinical strategy to triage women with abnormal cervical screening results immediately and effectively. In this study, the high-resolution microendoscopy combined with methylene blue cell staining technology was used to perform real-time in vivo imaging of the cervix for the first time.
A total of 41 patients were enrolled in the study. All patients underwent routine colposcopy and cervical biopsy, and high-resolution images of methylene blue-stained cervical lesions were obtained in vivo using microendoscopy. The cell morphological features of benign and neoplastic cervical lesions stained with methylene blue under microendoscopy were analyzed and summarized. The microendoscopy and histopathology findings of the high-grade squamous intraepithelial lesion (HSIL) and more severe lesions were compared.
The overall consistency of microendoscopy diagnosis with pathological diagnosis was 95.12% (39/41). Diagnostic cell morphological features of cervicitis, low-grade squamous intraepithelial lesion (LSIL), HSIL, adenocarcinoma in situ, and invasive cancer were clearly demonstrated in methylene blue stained microendoscopic images. In HSIL and more severe lesions, microendoscopic methylene blue cell staining technology can show the microscopic diagnostic features consistent with histopathology.
This study was an initial exercise in the application of the microendoscopy imaging system combined with methylene blue cell staining technology to cervical precancerous lesions and cervical cancer screening. The results provided the basis for a novel clinical strategy for triage of women with abnormal cervical screening results using in vivo non-invasive optical diagnosis technology.
宫颈癌是一个重要的公共卫生问题。传统阴道镜检查在诊断宫颈病变方面效率低下，大量活检会造成创伤。迫切需要一种新的临床策略，以便立即有效地对宫颈筛查结果异常的女性进行分流。在本研究中，首次将高分辨率显微内镜与亚甲蓝细胞染色技术相结合，对宫颈进行实时体内成像。
本研究共纳入41例患者。所有患者均接受了常规阴道镜检查和宫颈活检，并使用显微内镜在体内获取了亚甲蓝染色宫颈病变的高分辨率图像。分析并总结了显微内镜下亚甲蓝染色的良性和肿瘤性宫颈病变的细胞形态特征。比较了高级别鳞状上皮内病变（HSIL）及更严重病变的显微内镜检查结果与组织病理学结果。
显微内镜诊断与病理诊断的总体一致性为95.12%（39/41）。亚甲蓝染色的显微内镜图像清晰显示了宫颈炎、低级别鳞状上皮内病变（LSIL）、HSIL、原位腺癌和浸润癌的诊断性细胞形态特征。在HSIL及更严重病变中，显微内镜亚甲蓝细胞染色技术可显示与组织病理学一致的微观诊断特征。
本研究是将显微内镜成像系统与亚甲蓝细胞染色技术应用于宫颈前病变和宫颈癌筛查的初步尝试。研究结果为采用体内非侵入性光学诊断技术对宫颈筛查结果异常的女性进行分流的新型临床策略提供了依据。
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