Probe-based confocal laser endomicroscopy intra-operative evaluation in ovarian cancer: definition of in vivo architectural patterns to determine resection strategies.

IF 4.1 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Paola Spessotto, Nicolò Clemente, Maurizio Mongiat, Alessandra Capuano, Gustavo Baldassarre, Jerry Polesel, Anna Del Fabro, Emilio Lucia, Stefano Realdon, Stefania Maiero, Vincenzo Canzonieri, Giorgio Giorda, Renato Cannizzaro, Antonino Ditto
{"title":"Probe-based confocal laser endomicroscopy intra-operative evaluation in ovarian cancer: definition of in vivo architectural patterns to determine resection strategies.","authors":"Paola Spessotto, Nicolò Clemente, Maurizio Mongiat, Alessandra Capuano, Gustavo Baldassarre, Jerry Polesel, Anna Del Fabro, Emilio Lucia, Stefano Realdon, Stefania Maiero, Vincenzo Canzonieri, Giorgio Giorda, Renato Cannizzaro, Antonino Ditto","doi":"10.1016/j.ijgc.2024.101626","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Probe-based confocal laser endomicroscopy (pCLE) is a novel real-time imaging technique that is potentially useful for accurately distinguishing between normal and cancerous tissues. The aim of this study was to describe the pCLE patterns of areas suggestive of tumors and evaluate the ability of the method to differentiate between normal and cancerous tissue during cytoreductive surgery for epithelial ovarian cancer.</p><p><strong>Methods: </strong>In vivo pCLE images and subsequent biopsies were acquired from various anatomical sites including the parietal and visceral peritoneum, ovaries, and omentum. Each endomicroscopic sequence was analyzed by highly experienced investigators using pCLE imaging for cancer diagnosis. Each pCLE sequence was compared with the histology of the corresponding specimens.</p><p><strong>Results: </strong>We enrolled 18 women with International Federation of Gynecology and Obstetrics stage III/IV high-grade serous epithelial ovarian cancer referred for primary or interval debulking surgery. A total of 112 biopsies were obtained for histologic analysis. The pCLE images of normal tissue showed a regular distribution of stromal fibers and consistent cellular architecture, regardless of the anatomical region, with vascularized areas characterized by regular vessels. Conversely, the extravasation of fluorescein, used as a contrast agent, was a distinguishing feature of malignant nodules, which were easily recognized by leakage and are typical of tumor-associated vessels. The leakage often surrounded the dark clusters of neoplastic cells. A substantial agreement between pCLE and histology emerged (k = 0.66), whereas only a fair concordance between the surgeon's intra-operative assessment and histology was found (k = 0.30).</p><p><strong>Conclusions: </strong>Our results suggest that pCLE is a promising intra-operative technique to assist surgeons in accurately detecting peritoneal metastases in patients with advanced epithelial ovarian cancer, enhancing surgical radicality while avoiding unnecessary resection.</p>","PeriodicalId":14097,"journal":{"name":"International Journal of Gynecological Cancer","volume":"35 2","pages":"101626"},"PeriodicalIF":4.1000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Gynecological Cancer","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ijgc.2024.101626","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Probe-based confocal laser endomicroscopy (pCLE) is a novel real-time imaging technique that is potentially useful for accurately distinguishing between normal and cancerous tissues. The aim of this study was to describe the pCLE patterns of areas suggestive of tumors and evaluate the ability of the method to differentiate between normal and cancerous tissue during cytoreductive surgery for epithelial ovarian cancer.

Methods: In vivo pCLE images and subsequent biopsies were acquired from various anatomical sites including the parietal and visceral peritoneum, ovaries, and omentum. Each endomicroscopic sequence was analyzed by highly experienced investigators using pCLE imaging for cancer diagnosis. Each pCLE sequence was compared with the histology of the corresponding specimens.

Results: We enrolled 18 women with International Federation of Gynecology and Obstetrics stage III/IV high-grade serous epithelial ovarian cancer referred for primary or interval debulking surgery. A total of 112 biopsies were obtained for histologic analysis. The pCLE images of normal tissue showed a regular distribution of stromal fibers and consistent cellular architecture, regardless of the anatomical region, with vascularized areas characterized by regular vessels. Conversely, the extravasation of fluorescein, used as a contrast agent, was a distinguishing feature of malignant nodules, which were easily recognized by leakage and are typical of tumor-associated vessels. The leakage often surrounded the dark clusters of neoplastic cells. A substantial agreement between pCLE and histology emerged (k = 0.66), whereas only a fair concordance between the surgeon's intra-operative assessment and histology was found (k = 0.30).

Conclusions: Our results suggest that pCLE is a promising intra-operative technique to assist surgeons in accurately detecting peritoneal metastases in patients with advanced epithelial ovarian cancer, enhancing surgical radicality while avoiding unnecessary resection.

基于探针的共聚焦激光内镜在卵巢癌术中评估:体内结构模式的定义,以确定切除策略。
目的:基于探针的共聚焦激光内镜(pCLE)是一种新型的实时成像技术,可用于准确区分正常组织和癌组织。本研究的目的是描述提示肿瘤区域的pCLE模式,并评估该方法在上皮性卵巢癌细胞减少手术中区分正常组织和癌组织的能力。方法:从腹膜壁和内脏、卵巢和网膜等不同解剖部位获得pCLE的活体图像和随后的活检。每个内镜序列分析由经验丰富的研究人员使用pCLE成像进行癌症诊断。将每个pCLE序列与相应标本的组织学进行比较。结果:我们纳入了18名患有国际妇产科联合会III/IV期高级别浆液上皮性卵巢癌的妇女,她们接受了原发性或间断性减体积手术。共获得112例活检进行组织学分析。正常组织的pCLE图像显示基质纤维的规则分布和一致的细胞结构,无论解剖区域如何,血管化区域以规则的血管为特征。相反,作为造影剂的荧光素外渗是恶性结节的一个显著特征,它很容易通过渗漏识别,是肿瘤相关血管的典型特征。渗漏常包围深色肿瘤细胞簇。pCLE与组织学之间存在实质性的一致(k = 0.66),而外科医生术中评估与组织学之间仅存在公平的一致性(k = 0.30)。结论:我们的研究结果表明,pCLE是一种很有前途的术中技术,可以帮助外科医生准确检测晚期上皮性卵巢癌患者的腹膜转移,增强手术根治性,同时避免不必要的切除。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
6.60
自引率
10.40%
发文量
280
审稿时长
3-6 weeks
期刊介绍: The International Journal of Gynecological Cancer, the official journal of the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology, is the primary educational and informational publication for topics relevant to detection, prevention, diagnosis, and treatment of gynecologic malignancies. IJGC emphasizes a multidisciplinary approach, and includes original research, reviews, and video articles. The audience consists of gynecologists, medical oncologists, radiation oncologists, radiologists, pathologists, and research scientists with a special interest in gynecological oncology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信