基于探针的共聚焦激光显微内镜用于耳廓基底细胞癌的光学活检。
Probe-based confocal laser endomicroscopy for optical biopsy of basal cell carcinoma of the auricle.
文献信息
| PMID | 42708436 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Flurin Müller-Diesing |
| 作者单位 | Department of Otorhinolaryngology, Head and Neck Surgery, Uniklinik RWTH Aachen University, Aachen, Germany. |
| 期刊 | Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale |
| SCI 分区 | Q1 |
| IF | 2.4 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 耳廓皮肤肿瘤的切除面临着既要尽可能缩小切除缺损，又要实现完全切除的挑战。基于探针的共聚焦激光显微内镜（CLE）是一种光学检查方法，可在体内以高达1000倍的放大倍数对上皮进行实时、无创评估。本研究旨在评估CLE用于耳廓基底细胞癌（BCC）的可行性。
方法： 分析了8例不同耳廓BCC患者的64段CLE图像视频序列（4,872张图像）。每段视频序列均被赋予组织学诊断。这些序列以盲法呈现给4位具有CLE经验的医生。采用细胞大小、组织均质性和纤维化等标准对良恶性进行二分类评估。
结果： BCC的特征是组织不均匀，细胞增大、边界不清，部分被无细胞纤维化所中断。基于CLE序列的良恶性评估平均灵敏度为86.7%，特异度为94.5%。评分者间信度（Fleiss Kappa）显示高度一致（κ = 0.76）。
结论： 结果初步证明了术中CLE用于面部皮肤肿瘤光学活检的可行性。该技术有潜力作为术中决策的无创诊断工具。仍需进一步研究以评估其作为辅助手段在BCC治疗中优化或减少侵入性冰冻切片病理检查使用的价值。
英文摘要
OBJECTIVE: The resection of skin tumours of the auricle is confronted with the challenge of keeping the resection defect as small as possible and at the same time achieving a complete resection. Probe-based confocal laser endomicroscopy (CLE) is an optical procedure that enables real-time, non-invasive assessment of the epithelium with up to 1000x magnification in vivo. The aim is to evaluate the feasibility of CLE in basal cell carcinoma (BCC) of the auricle.
METHODS: Sixty-four video sequences (4,872 images) of CLE images of 8 different patients with BCC on the auricle were analysed. Each video sequence was assigned a histologic diagnosis. The sequences were presented to 4 physicians with experience in CLE in a blinded fashion. Dignity was assessed dichotomously using criteria such as cell size, tissue homogeneity and fibrosis.
RESULTS: BCC is characterised by inhomogeneous tissue with enlarged, poorly demarcated cells, partly interrupted by cell-free fibrosis. The assessment of dignity based on the CLE sequences achieved an average sensitivity of 86.7% and a specificity of 94.5%. The interrater reliability (Fleiss Kappa) showed substantial agreement (κ = 0.76).
CONCLUSIONS: The results demonstrate the initial feasibility of intraoperative CLE for optical biopsy of facial skin tumours. The technique has the potential to serve as a non-invasive diagnostic tool in intraoperative decision making. Further studies are needed to evaluate its use as an adjunct to optimise or reduce the use of invasive frozen section pathology in the treatment of BCC.