Di Matteo Francesco Maria, Stigliano Serena, Frasca Luca, Biasutto Dario, Maricchiolo Giulia, Morano Vittoria, Taffon Chiara, Crescenzi Anna
Operative Endoscopy Department, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Unit of Thoracic Surgery, Fondazione Policlinico Universitario Campus-Biomedico, 00128 Rome, Italy.
Cancers (Basel). 2024 Nov 29;16(23):4015. doi: 10.3390/cancers16234015.
: Ex vivo fluorescence laser scanning microscopes (FCMs) allow digital tissue imaging directly from fresh, unfixed specimens without the need for conventional histological slide preparation. To date, no data have been reported on the use of FCMs in the endoscopy suite for immediate evaluation of endoscopic ultrasound (EUS)/endobronchial ultrasound (EBUS) fine needle aspiration/biopsy (FNA-B) specimens of lung lesions and/or mediastinal lymph nodes. : The aim of this study was to evaluate the performance of the FCM Vivascope 2500 (Vivascope, Munich, Germany) in providing real-time adequacy assessment and diagnostic information on the digital images of fresh unprocessed EUS/EBUS FNA-B specimens and to compare it with the corresponding final histological sections of formalin-fixed and paraffin-embedded cell blocks. : Thirty-two patients (50% male; 71 ± 8 years old) were enrolled between May 2023 and June 2024. In 28/32 (87.5%) patients, samples were defined as adequate at Vivascope evaluation, and in 20/28 (71.4%) patients, samples were classified as malignant. At final cytohistological evaluation, 87.5% of specimens were defined as adequate and 20/28 (71.4%) were diagnosed as malignant. There was perfect agreement between the Vivascope assessment of adequacy and the final cytohistological assessment on the same specimen (k Cohen 1). From a diagnostic point of view, perfect agreement was found between the two techniques in the identification of malignant neoplasms (k Cohen 1). : The use of FCM could provide rapid information on both the adequacy and malignancy of the sample obtained during EBUS tissue acquisition (EBUS-TA), with minimal or no preparation and without destroying or losing the tissue. This technique allows for obtaining representative material in EBUS/EUS for lung cancer staging and is expected to change the turnaround time from biopsy sampling to diagnostic characterization of the tumor, ultimately improving patient management both at diagnosis and at restaging in follow up.
离体荧光激光扫描显微镜（FCMs）可直接对新鲜、未固定的标本进行数字组织成像，无需进行传统的组织学玻片制备。迄今为止，尚无关于在内镜检查室中使用FCMs对肺部病变和/或纵隔淋巴结的内镜超声（EUS）/支气管内超声（EBUS）细针穿刺抽吸/活检（FNA - B）标本进行即时评估的数据报道。
本研究的目的是评估FCM Vivascope 2500（德国慕尼黑的Vivascope公司）在为新鲜未处理的EUS/EBUS FNA - B标本的数字图像提供实时充分性评估和诊断信息方面的性能，并将其与福尔马林固定石蜡包埋细胞块的相应最终组织学切片进行比较。
2023年5月至2024年6月期间招募了32例患者（50%为男性；年龄71±8岁）。在28/32（87.5%）例患者中，Vivascope评估样本为充足，在20/28（71.4%）例患者中，样本被分类为恶性。在最终的细胞组织学评估中，87.5%的标本被定义为充足，20/28（71.4%）被诊断为恶性。Vivascope对充足性的评估与同一标本的最终细胞组织学评估之间存在完美一致性（科恩k值为1）。从诊断角度来看，两种技术在识别恶性肿瘤方面存在完美一致性（科恩k值为1）。
使用FCM可以在EBUS组织获取（EBUS - TA）过程中对所取样本的充足性和恶性程度提供快速信息，只需极少的准备工作或无需准备，且不会破坏或丢失组织。该技术能够在EBUS/EUS中获取用于肺癌分期的代表性材料，预计将改变从活检采样到肿瘤诊断特征分析的周转时间，最终改善患者在诊断和随访再分期时的管理。
