Background: Intraoperative frozen sections (FS) are frequently used to establish the diagnosis of lung cancer when preoperative examinations are not conclusive. The downside of FS is its resource-intensive nature and the risk of tissue depletion when small lesions are assessed. Ex vivo fluorescence confocal microscopy (FCM) is a novel microimaging method for loss-free examinations of native materials. We tested its suitability for the intraoperative diagnosis of lung tumors. Methods: Samples from 59 lung resection specimens containing 45 carcinomas were examined in the FCM. The diagnostic performance in the evaluation of malignancy and histological typing of lung tumors was evaluated in comparison with FS and the final diagnosis. Results: A total of 44/45 (98%) carcinomas were correctly identified as malignant in the FCM. A total of 33/44 (75%) carcinomas were correctly subtyped, which was comparable with the results of FS and conventional histology. Our tests documented the excellent visualization of cytological features of normal tissues and tumors. Compared to FS, FCM was technically less demanding and less personnel intensive. Conclusions: The ex vivo FCM is a fast, effective, and safe method for diagnosing and subtyping lung cancer and is, therefore, a promising alternative to FS. The method preserves the tissue without loss for subsequent examinations, which is an advantage in the diagnosis of small tumors and for biobanking.
背景：当术前检查无法确诊时，术中冰冻切片（FS）常用于肺癌的诊断。然而，冰冻切片的缺点在于其资源密集性，且在评估小病灶时存在组织损耗的风险。离体荧光共聚焦显微镜（FCM）是一种新型显微成像方法，可对原始材料进行无损检查。本研究测试了其在肺肿瘤术中诊断中的适用性。 方法：对59例肺切除标本中的45例癌组织样本进行了FCM检查。通过与冰冻切片及最终诊断结果进行比较，评估了FCM在肺肿瘤恶性判断及组织学分型方面的诊断性能。 结果：FCM正确识别出44/45（98%）的癌组织为恶性。其中33/44（75%）的癌组织被正确分型，这一结果与冰冻切片及常规组织学检查相当。我们的测试证实，FCM能清晰显示正常组织和肿瘤的细胞学特征。与冰冻切片相比，FCM在技术要求和人员投入方面均较低。 结论：离体FCM是一种快速、有效且安全的肺癌诊断与分型方法，因此是冰冻切片的有前景的替代方案。该方法能完整保留组织以供后续检查，这对于小肿瘤的诊断及生物样本库建设具有显著优势。
肿瘤(癌症)患者之家