荧光共聚焦显微镜(FCM)是一种光学成像技术,以实时方式提供新鲜组织的数字显微图像,无需常规处理。FCM已广泛应用于皮肤科的多个领域,包括基底细胞癌和皮肤炎性疾病的检测。本文的目的是概述FCM在前列腺组织解释和前列腺癌(PCa)检测领域的应用。进行了文献检索(PubMed&WebofScience),以确定与FCM在前列腺和前列腺周围组织解释中的临床和外科应用有关的文章。总的来说,确定了六篇文章。所有文章都调查了FCM和常规组织病理学分析(苏木精-伊红,HE)用于区分正常组织和PCa组织。发现了一篇关于从根治性前列腺切除术(RP)标本中检索到的前列腺样本的研究文章,以及来自同一系列的FCM数字图像图集。两项前瞻性临床试验,比较FCM和HE,指出FCM对前列腺活检核心PCa诊断的“实质性”到“几乎完美”的判别性能。最后,两项研究调查了FCM在RP术中控制手术夹层的作用。在此设置中,FCM可用于分析从可疑前列腺周围区域获取的样本;FCM还经过了对从前列腺后外侧方面的系统采样中获得的扁平切片的正面评估测试,类似神经安全的方法。一般来说,FCM以实时方式提供新鲜组织的数字显微图像,不需要常规处理。目前,现有的研究证实了与常规病理学检测PCa的高度一致性.需要进一步的研究来验证该技术,评估ISUP评分归因,并实施FCM在前列腺疾病治疗中的应用领域。
Fluorescence confocal microscopy (FCM) is an optical imaging technique providing digital microscopical images of fresh tissue in a real time fashion, without conventional processing. FCM has been widely applied in several fields of dermatology, including the detection of basal cell carcinoma and of cutaneous inflammatory diseases. The aim of the paper is to provide an overview of FCM applications in the field of prostate tissue interpretation and prostate cancer (PCa) detection. A Literature search (PubMed & Web of Science) was performed to identify articles concerned with the clinical and surgical applications of FCM in prostatic and periprostatic tissues interpretation. Overall, six articles were identified. All articles investigated the level of agreement between FCM and conventional histopathological analysis (hematoxylin-eosin, HE) for the discrimination between normal and PCa tissues. An investigative article on prostate samples retrieved from radical prostatectomy (RP) specimens and an atlas of FCM digital images from the same series were found. Two prospective clinical trials, comparing FCM and HE, pointed out a \"substantial\" to \"almost perfect\" discriminative performance of FCM for the diagnosis of PCa on prostate biopsy core. Finally, two studies investigated the intra-operative role of FCM during RP for the control of surgical dissection. In this setting, FCM could be used to analyse samples retrieved from suspicious peri-prostatic areas; FCM has also been tested for an en-face evaluation of flat slices obtained from the systematic sampling of the posterolateral aspects of the prostate, in a NeuroSAFE-like approach. Generally, FCM provides digital microscopical images of fresh tissue in a real time fashion, without requiring conventional processing. Currently, available studies confirmed a high concordance with conventional pathology for the detection of PCa. Further studies are required to validate the technology, to evaluate ISUP score attribution and to implement the fields of application of FCM for the treatment of prostate diseases.