Multiphoton Microscopy: A Potential 'Optical Biopsy' Tool for Real-Time Evaluation of Lung Tumors Without the Need for Exogenous Contrast Agents
Autor: | Joshua Sterling, Brendon M. Stiles, Bekheit Salamoon, Sushmita Mukherjee, Manu Jain, Navneet Narula, Watt W. Webb, Nasser K. Altorki, Vishal Chandel, Amit Aggarwal, Maria M. Shevchuk |
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Rok vydání: | 2013 |
Předmět: |
Adult
Pathology medicine.medical_specialty Lung Neoplasms Pilot Projects Adenocarcinoma Pathology and Forensic Medicine Cohort Studies Lesion medicine Carcinoma Humans Neoplasm Invasiveness Atypical adenomatous hyperplasia Diagnostic Errors Lung Hyperplasia Carcinoma Acinar Cell business.industry Cell Differentiation General Medicine Optical Biopsy medicine.disease Neoplasm Proteins Tumor Burden Up-Regulation Medical Laboratory Technology Microscopy Fluorescence Multiphoton medicine.anatomical_structure Multiphoton fluorescence microscope Carcinoma Squamous Cell New York City Collagen medicine.symptom business |
Zdroj: | Archives of Pathology & Laboratory Medicine. 138:1037-1047 |
ISSN: | 1543-2165 0003-9985 |
Popis: | Context.—Multiphoton microscopy (MPM) is an emerging, nonlinear, optical-biopsy technique, which can generate subcellular-resolution images from unprocessed and unstained tissue in real time. Objective.—To assess the potential of MPM for lung tumor diagnosis. Design.—Fresh sections from tumor and adjacent nonneoplastic lung were imaged with MPM and then compared with corresponding hematoxylin-eosin slides. Results.—Alveoli, bronchi, blood vessels, pleura, smokers' macrophages, and lymphocytes were readily identified with MPM in nonneoplastic tissue. Atypical adenomatous hyperplasia (a preinvasive lesion) was identified in tissue adjacent to the tumor in one case. Of the 25 tumor specimens used for blinded pathologic diagnosis, 23 were diagnosable with MPM. Of these 23 cases, all but one adenocarcinoma (15 of 16; 94%) was correctly diagnosed on MPM, along with their histologic patterns. For squamous cell carcinoma, 4 of 7 specimens (57%) were correctly diagnosed. For the remaining 3 squamous cell carcinoma specimens, the solid pattern was correctly diagnosed in 2 additional cases (29%), but it was not possible to distinguish the squamous cell carcinoma from adenocarcinoma. The other squamous cell carcinoma specimen (1 of 7; 14%) was misdiagnosed as adenocarcinoma because of pseudogland formation. Invasive adenocarcinomas with acinar and solid pattern showed statistically significant increases in collagen. Interobserver agreement for collagen quantification (among 3 observers) was 80%. Conclusions.—Our pilot study provides a proof of principle that MPM can differentiate neoplastic from nonneoplastic lung tissue and identify tumor subtypes. If confirmed in a future, larger study, we foresee real-time intraoperative applications of MPM, using miniaturized instruments for directing lung biopsies, assessing their adequacy for subsequent histopathologic analysis or banking, and evaluating surgical margins in limited lung resections. |
Databáze: | OpenAIRE |
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