Abstract：
Fluorescence confocal microscopy (FCM) is an optical technique that uses laser light sources of different wavelengths to generate real-time images of fresh, unfixed tissue specimens. Unlike conventional histological evaluation methods, FCM is able to assess fresh tissue samples without the associated cryo artifacts typically observed after frozen sectioning. The purpose of this study was to evaluate the utility of FCM imaging in the differential diagnosis of cervical lymphadenopathy. Twenty-two cervical lymph node specimens from patients with lymphadenopathy of unknown origin were imaged by FCM. Two pathologists independently evaluated the scans for suspicion of malignancy and preliminary diagnosis. Malignancy was reliably excluded or confirmed by both pathologists with a sensitivity of 90.9% for pathologist 1 and 100% for pathologist 2. The specificity was 100% for both pathologists. For the preliminary diagnosis, almost perfect agreement with the final diagnosis was observed for both pathologists (κ= 0.94 for pathologist 1 and κ= 1.00 for pathologist 2). This is the first study to investigate lymph node specimens with different diagnoses, including lymphoma, using FCM. Our results indicate that differential diagnosis of lymph node specimens is feasible in FCM images, thus encouraging further exploration of FCM imaging in lymph node specimens to accelerate diagnosis and open the possibility of digitizing diagnosis on fresh, unfixed tissue.
摘要：
荧光共聚焦显微镜（FCM）是一种光学技术，它使用不同波长的激光光源来生成新鲜的实时图像，未固定的组织标本。与传统的组织学评估方法不同，FCM能够评估新鲜组织样品,而没有通常在冷冻切片后观察到的相关冷冻伪影。这项研究的目的是评估FCM成像在颈淋巴结病的鉴别诊断中的实用性。FCM对来自不明原因淋巴结病患者的22例颈部淋巴结标本进行了成像。两名病理学家独立评估扫描是否怀疑是恶性肿瘤和初步诊断。两位病理学家都可靠地排除或确认了恶性，病理学家1的敏感性为90.9％，病理学家2的敏感性为100％。两位病理学家的特异性为100%。对于初步诊断，两位病理学家的最终诊断几乎完全吻合（病理学家1的κ=0.94，病理学家2的κ=1.00）。这是第一项调查不同诊断的淋巴结标本的研究，包括淋巴瘤,使用FCM。我们的结果表明，在FCM图像中淋巴结标本的鉴别诊断是可行的，因此，鼓励进一步探索淋巴结标本中的FCM成像，以加速诊断并打开数字化诊断的可能性，未固定的组织。
