A Prospective Double-Blinded Comparison of Reflectance Confocal Microscopy with Conventional Histopathology for In Vivo Assessment in Oral Cancer.

Autor:	Zanoni DK; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Radiology, University of Iowa, Iowa City, Iowa., Demétrio De Souza França P; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.; Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil., Valero C; Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York., Peterson G; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Ardigo M; San Gallicano Dermatological Institute IRCCS, Rome, Italy., Ghossein R; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York., Dusza SW; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Matsuura D; Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York., Scholfield DW; Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York., Adilbay D; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York., Montero PH; Clínica Las condes Hospital Dr. Sótero del Rio Estoril, Santiago, Chile., Migliacci J; Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York., Pillarsetty NVK; Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York., Kose K; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Ganly I; Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York., Rajadhyaksha M; Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Patel SG; Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Jazyk:	angličtina
Zdroj:	Clinical cancer research : an official journal of the American Association for Cancer Research [Clin Cancer Res] 2024 Jun 03; Vol. 30 (11), pp. 2486-2496.
DOI:	10.1158/1078-0432.CCR-23-1361
Abstrakt:	Purpose: We investigated reflectance confocal microscopy (RCM) as a possible noninvasive approach for the diagnosis of cancer and real-time assessment of surgical margins. Experimental Design: In a phase I study on 20 patients, we established the RCM imaging morphologic features that distinguish oral squamous cell carcinoma (OSCC) from normal tissue with a newly developed intraoral RCM probe. Our subsequent phase II prospective double-blinded study in 60 patients tested the diagnostic accuracy of RCM against histopathology. Five RCM videos from the tumor and five from normal surrounding mucosa were collected on each patient, followed by a 3-mm punch biopsy of the imaged area. An experienced RCM reader, who was blinded to biopsy location and histologic diagnosis, examined the videos from both regions and classified each as "tumor" or "not tumor" based on RCM features established in phase I. Hematoxylin and eosin slides from the biopsies were read by a pathologist who was blinded to RCM results. Using histology as the gold standard, we calculated the sensitivity and specificity of RCM. Results: We report a high agreement between the blinded readers (95% for normal tissue and 81.7% for tumors), high specificity (98.3%) and negative predictive values (96.6%) for normal tissue identification, and high sensitivity (90%) and positive predictive values (88.2%) for tumor detection. Conclusions: RCM imaging is a promising technology for noninvasive in vivo diagnosis of OSCC and for real-time intraoperative evaluation of mucosal surgical margins. Its inherent constraint, however, stems from the diminished capability to evaluate structures located at more substantial depths within the tissue. (©2024 The Authors; Published by the American Association for Cancer Research.)
Databáze:	MEDLINE
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