Liu Xiaojing, Cui Miao, Feng Cuixia, Jin Shujuan, Han Xiaowei, Wu Yongfang, Meng Di, Zuo Si, Xu Qing, Tai YanHong, Liang Feng
Senior Department of General Surgery, The First Medical Center of Chinese, PLA General Hospital, Fuxing Road, No. 28, Haidian District, Beijing, 100853, China.
Department of Pathology, Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China.
J Cancer Res Clin Oncol. 2025 Feb 14;151(2):83. doi: 10.1007/s00432-025-06125-w.
Breast cancer patients undergoing breast-conserving surgery may require a second operation if positive margins persist but current intraoperative methodologies often lack real-time and comprehensive assessments of tissue margins. This study addresses this critical gap by introducing a novel approach to enhance margin assessment in breast surgery.
A total of 252 fresh tissue blocks from 199 patients with different types of breast lesions were scanned with a customized swept-source optical coherence tomography (SS-OCT) system, and the OCT features of normal, benign, and malignant breast tissues, were systematically analyzed.
The qualitative analysis results revealed that adipose tissue has high penetration depth and a typical honeycomb pattern, whereas fibrous tissue has the brightest grayscale values and a bundle-like structure. The lobular area appears as a dark region, and dilated ducts present a distinct tubular structure on B-scan images. Adenosis results in bright areas, fibroadenoma results in typical contour structures, phyllodes tumors present lobular structures, invasive carcinomas present a stellate pattern and low penetration depth, and mucinous carcinoma cancer cells are clearly visible within the low-scattering mucin.
Importantly, we provide comparative OCT and hematoxylin and eosin (H&E) histology images for less common conditions, such as phyllodes tumors, intraductal papillomas, and mucinous carcinoma. For the first time, we established an 3D OCT-histopathology library with a large field of view and systematically analyzed the multidimensional features. This work strongly supports the feasibility of using OCT technology intraoperatively in surgery. Additionally, the OCT-histopathology library can help pathologists better understand and identify tissue features, thereby enhancing diagnostic efficiency.
接受保乳手术的乳腺癌患者若切缘持续阳性可能需要二次手术，但目前的术中方法往往缺乏对组织切缘的实时和全面评估。本研究通过引入一种新方法来加强乳腺手术中的切缘评估，以填补这一关键空白。
使用定制的扫频光学相干断层扫描（SS-OCT）系统对199例不同类型乳腺病变患者的252个新鲜组织块进行扫描，并系统分析正常、良性和恶性乳腺组织的OCT特征。
定性分析结果显示，脂肪组织具有高穿透深度和典型的蜂窝状图案，而纤维组织具有最亮的灰度值和束状结构。小叶区域表现为暗区，扩张的导管在B扫描图像上呈现出明显的管状结构。腺病导致亮区，纤维腺瘤导致典型的轮廓结构，叶状肿瘤呈现小叶结构，浸润性癌呈现星状图案且穿透深度低，黏液癌的癌细胞在低散射黏液内清晰可见。
重要的是，我们提供了针对叶状肿瘤、导管内乳头状瘤和黏液癌等不太常见情况的OCT与苏木精和伊红（H&E）组织学对比图像。我们首次建立了具有大视野的三维OCT-组织病理学库，并系统分析了多维特征。这项工作有力地支持了术中使用OCT技术的可行性。此外，OCT-组织病理学库可帮助病理学家更好地理解和识别组织特征，从而提高诊断效率。
