In-Vivo LC-OCT evaluation of the downward proliferation pattern of keratinocytes in actinic keratosis in comparison with histology: first impressions from a pilot study
| Autor: | Cristel Ruini, Sandra Schuh, Daniela Hartmann, Lars E. French, Elke Sattler, Charlotte Gust, Julia Welzel |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
PRO
Dysplasia Cancer Research medicine.medical_specialty Pathology line-field confocal optical coherence tomography Line-field confocal optical coherence tomography Keratinocyte cancer 01 natural sciences Actinic keratosis Bedside histology Field cancerization Non-invasive diagnostics in dermatology Skin imaging Article 010309 optics 030207 dermatology & venereal diseases 03 medical and health sciences Basal (phylogenetics) 0302 clinical medicine dysplasia 0103 physical sciences medicine actinic keratosis keratinocyte cancer ddc:610 Grading (tumors) RC254-282 business.industry skin imaging Neoplasms. Tumors. Oncology. Including cancer and carcinogens Histology bedside histology medicine.disease Oncology Histopathology field cancerization business non-invasive diagnostics in dermatology Kappa |
| Zdroj: | Cancers Volume 13 Issue 12 Pages: 2856 Cancers, Vol 13, Iss 2856, p 2856 (2021) |
| Popis: | Simple Summary Actinic keratoses (AKs) are extremely common in the elderly population; they are universally recognized as precursors of invasive squamous cell carcinoma, and their risk of progression relates to the basal growth pattern of keratinocytes in the histological slides, based on a model called “PRO” classification. Since AKs can be investigated at bedside with non-invasive devices such the new line-field confocal optical coherence tomography (LC-OCT), we hypothesized that it was also possible to use such devices for reproducing the PRO classification and assessing the progression risk of AK without an invasive biopsy. In this pilot study, we demonstrated the feasibility of the LC-OCT severity grading of AKs based on the histological PRO classification, obtaining a good correlation between the two models and strong interobserver agreement. Abstract It is known that actinic keratoses (AKs) can progress to invasive squamous cell carcinoma (SCC). The histological PRO grading of AKs is based on the growth pattern of basal keratinocytes and relates to their progression risk. AKs can be non-invasively characterized by line-field confocal optical coherence tomography (LC-OCT). The aim of the study was to define criteria for an LC-OCT grading of AKs based on the PRO classification and to correlate it with its histological counterpart. To evaluate the interobserver agreement for the LC-OCT PRO classification, fifty AKs were imaged by LC-OCT and biopsied for histopathology. PRO histological grading was assessed by an expert consensus, while two evaluator groups separately performed LC-OCT grading on vertical sections. The agreement between LC-OCT and histological PRO grading was 75% for all lesions (weighted kappa 0.66, 95% CI 0.48–0.83, p ≤ 0.001) and 85.4% when comparing the subgroups PRO I vs. PRO II/III (weighted kappa 0.64, 95% CI 0.40–0.88, p ≤ 0.001). The interobserver agreement for LC-OCT was 90% (Cohen’s kappa 0.84, 95% CI 0.71–0.91, p ≤ 0.001). In this pilot study, we demonstrated that LC-OCT is potentially able to classify AKs based on the basal growth pattern of keratinocytes, in-vivo reproducing the PRO classification, with strong interobserver agreement and a good correlation with histopathology. |
| Databáze: | OpenAIRE |
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