Background/Objectives: Pediatric gonadal tumors are rare tumors, and germ cell tumors (GCTs) are the most common subgroup. GCTs are heterogeneous tumors and have different subtypes that can be either benign or malignant. Therefore, extensive sampling of the resected tumor is required to obtain an accurate diagnosis. Higher harmonic generation microscopy (HHGM) is an innovative imaging technique that enables rapid visualization of fresh tissue without the need for preparation or staining. This makes it particularly valuable for sample selection, as the tissue can be reused for further analysis. This study aims to evaluate the accuracy of pathologists detecting normal gonadal tissue, germ cell tumors, and other pediatric gonadal tumors in HHGM images. Methods: Twenty-eight samples of twenty-two patients with a germ cell tumor or other gonadal tumor were imaged with the HHG microscope and subsequently processed for histology. Overview images of the samples were made in 10 s per mm2, and high-quality images in 1 min per mm2. A multi-observer study was performed with five expert pathologists. Results: Pathologists were able to differentiate between tumor and non-tumor tissue with an accuracy of 75% (21/28) on the HHGM images versus an accuracy of 89% (25/28) on the corresponding histology. Discrepancies mainly concerned teratoma cases for HHGM as well as H&E, indicating that sampling errors of these heterogeneous tumors affected the outcomes of this study adversely. Conclusions: Although the sample size was limited by the rarity of these tumors, our data show that HHGM is a promising technique for the rapid assessment of pediatric gonadal tumor samples, particularly in evaluating their representativeness.
背景/目的：儿童性腺肿瘤属于罕见肿瘤，其中生殖细胞肿瘤（GCTs）是最常见的亚型。GCTs具有高度异质性，包含多种可呈良性或恶性的亚型，因此需要对切除肿瘤进行广泛取样以获得准确诊断。高次谐波显微成像技术（HHGM）是一种创新的成像方法，无需组织处理或染色即可实现新鲜组织的快速可视化，这对样本选择具有重要价值，因为组织可重复用于后续分析。本研究旨在评估病理学家通过HHGM图像识别正常性腺组织、生殖细胞肿瘤及其他儿童性腺肿瘤的准确性。方法：对22例生殖细胞肿瘤或其他性腺肿瘤患者的28份样本进行HHG显微成像及后续组织学处理。样本概览图像以每平方毫米10秒的速度采集，高质量图像以每平方毫米1分钟的速度采集。研究采用五位资深病理学家参与的多观察者评估方案。结果：病理学家在HHGM图像中区分肿瘤与非肿瘤组织的准确率为75%（21/28），而在对应组织学切片中的准确率为89%（25/28）。差异主要涉及畸胎瘤病例在HHGM及H&E染色中的判读，表明这类异质性肿瘤的取样误差对本研究结果产生了不利影响。结论：尽管样本量受限于此类肿瘤的罕见性，但我们的数据表明HHGM是一种具有潜力的快速评估儿童性腺肿瘤样本的技术，尤其在评估样本代表性方面具有应用价值。
肿瘤(癌症)患者之家