Abstract: Background/Objectives: Sinonasal malignancies are rare and highly diverse cancers that pose significant diagnostic challenges due to their variable histological features and complex anatomical locations. Accurate diagnosis is critical for guiding treatment, yet conventional methods often require multiple biopsies. This study aimed to evaluate the potential of confocal laser endomicroscopy (CLE) for real-time imaging of sinonasal tumors to characterize specific features of different entities and improve diagnostic precision.Methods: Ten patients with various sinonasal malignancies, including squamous cell carcinoma, adenocarcinoma, sinonasal undifferentiated carcinoma, olfactory neuroblastoma, sinonasal mucosal melanoma, and endonasal lymphoma, were examined using CLE during diagnostic endoscopy. CLE images were compared descriptively with histopathological cross-sections to identify unique imaging patterns for each tumor type.Results: CLE was feasible across all cases, with high-quality images obtained despite anatomical challenges in some cases. Characteristic features, such as vascular clusters in undifferentiated carcinoma, mucin-filled bubbles in adenocarcinoma, and small round cells in neuroblastoma, were identified and corresponded well with histopathological findings. CLE also helped guide biopsies by revealing areas with diagnostic relevance.Conclusions: CLE demonstrates promise as an adjunct diagnostic tool in sinonasal malignancies, offering real-time imaging that correlates with histopathological findings and aids in targeted biopsies. While this study provides preliminary insights into the utility of CLE, further research with larger cohorts and statistical validation is necessary to establish its diagnostic reliability and broader clinical application.
摘要：背景/目的：鼻腔鼻窦恶性肿瘤是一类罕见且高度异质性的癌症，由于其组织学特征多变和解剖位置复杂，给诊断带来显著挑战。准确诊断对指导治疗至关重要，但传统方法常需多次活检。本研究旨在评估共聚焦激光显微内镜（CLE）在鼻腔鼻窦肿瘤实时成像中的应用潜力，以表征不同肿瘤实体的特异性特征，提高诊断精确度。方法：对10例患有不同鼻腔鼻窦恶性肿瘤（包括鳞状细胞癌、腺癌、鼻腔鼻窦未分化癌、嗅神经母细胞癌、鼻腔鼻窦黏膜黑色素瘤及鼻内淋巴瘤）的患者，在诊断性内镜检查中应用CLE进行观察。通过描述性方法将CLE图像与组织病理学切片进行比对，以识别各肿瘤类型的独特成像模式。结果：所有病例均成功实施CLE检查，尽管部分病例存在解剖学挑战，仍获得了高质量图像。研究识别出未分化癌中的血管簇、腺癌中的黏液填充气泡、神经母细胞癌中的小圆细胞等特征性表现，这些发现与组织病理学结果高度吻合。CLE还能通过显示具有诊断意义的区域来指导活检定位。结论：CLE作为鼻腔鼻窦恶性肿瘤的辅助诊断工具展现出应用前景，其提供的实时成像与组织病理学结果相关联，有助于实现靶向活检。尽管本研究为CLE的临床应用提供了初步依据，但仍需通过更大样本量的研究和统计学验证，以确立其诊断可靠性并拓展临床应用范围。
肿瘤(癌症)患者之家