Fluorescence Confocal Microscopy Can Accelerate Diagnosis of Cervical Lymphadenopathy

IF 7.1 1区 医学 Q1 PATHOLOGY Modern Pathology Pub Date : 2024-07-03 DOI:10.1016/j.modpat.2024.100559
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Abstract

Fluorescence confocal microscopy (FCM) is an optical technique that uses laser light sources of different wavelengths to generate real-time images of fresh, unfixed tissue specimens. Unlike conventional histologic evaluation methods, FCM is able to assess fresh tissue samples without the associated cryo artifacts typically observed after frozen sectioning. The purpose of this study was to evaluate the utility of FCM imaging in the differential diagnosis of cervical lymphadenopathy. Twenty-two cervical lymph node specimens from patients with lymphadenopathy of unknown origin were imaged by FCM. Two pathologists independently evaluated the scans for suspicion of malignancy and preliminary diagnosis. Malignancy was reliably excluded or confirmed by both pathologists with a sensitivity of 90.9% for pathologist 1 and 100% for pathologist 2. The specificity was 100% for both pathologists. For the preliminary diagnosis, almost perfect agreement with the final diagnosis was observed for both pathologists (κ = 0.94 for pathologist 1 and κ = 1.00 for pathologist 2). This is the first study to investigate lymph node specimens with different diagnoses, including lymphoma, using FCM. Our results indicate that differential diagnosis of lymph node specimens is feasible in FCM images, thus encouraging further exploration of FCM imaging in lymph node specimens to accelerate diagnosis and open the possibility of digitizing diagnosis on fresh, unfixed tissue.

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荧光共聚焦显微镜可加快宫颈淋巴结病的诊断。
荧光共聚焦显微镜(FCM)是一种光学技术,利用不同波长的激光光源生成新鲜、未固定组织标本的实时图像。与传统的组织学评估方法不同,FCM 能够对新鲜组织样本进行评估,而不会出现通常在冷冻切片后观察到的相关冷冻伪影。本研究旨在评估 FCM 成像在宫颈淋巴结病鉴别诊断中的实用性。对 22 例来源不明的淋巴结病患者的颈淋巴结标本进行了 FCM 成像。两名病理学家对扫描结果进行独立评估,以怀疑恶性肿瘤并作出初步诊断。两位病理学家均能可靠地排除或确诊恶性肿瘤,其中病理学家 1 的敏感性为 90.9%,病理学家 2 为 100%,两位病理学家的特异性均为 100%。两位病理学家的初步诊断与最终诊断几乎完全一致(病理学家 1 的κ= 0.94,病理学家 2 的κ= 1.00)。这是首次使用 FCM 对包括淋巴瘤在内的不同诊断的淋巴结标本进行研究。我们的结果表明,在 FCM 图像中对淋巴结标本进行鉴别诊断是可行的,因此鼓励进一步探索在淋巴结标本中进行 FCM 成像,以加快诊断速度,并为在新鲜、未固定的组织上进行数字化诊断提供了可能。
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来源期刊
Modern Pathology
Modern Pathology 医学-病理学
CiteScore
14.30
自引率
2.70%
发文量
174
审稿时长
18 days
期刊介绍: Modern Pathology, an international journal under the ownership of The United States & Canadian Academy of Pathology (USCAP), serves as an authoritative platform for publishing top-tier clinical and translational research studies in pathology. Original manuscripts are the primary focus of Modern Pathology, complemented by impactful editorials, reviews, and practice guidelines covering all facets of precision diagnostics in human pathology. The journal's scope includes advancements in molecular diagnostics and genomic classifications of diseases, breakthroughs in immune-oncology, computational science, applied bioinformatics, and digital pathology.
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