Abstract 907P
Background
The frozen section preparation is the most widely utilized method for instant histologic evaluation of fresh tissue; however, processing time and preparation artifacts demand a novel technique for the instant histologic evaluation of the tissue. A recently developed confocal laser endomicroscopic system provides real-time imaging of the tissue without glass slide preparation. We here evaluated its applicability in gastric cancer tissues.
Methods
cCeLL-A 488, a confocal laser endomicroscopic system using 488 nm light with a Lissajous pattern laser scanning, was developed for real-time imaging of the tissues. Twenty-seven formalin-fixed, twelve frozen, and six fresh advanced gastric cancer tissues and the same number of normal gastric tissues were obtained from fourteen patients. Fluorescein sodium was used for staining. Five pathologists interpreted 100 endomicroscopic images and decide their histologic locations and the presence of cancer. Following the review of matched hematoxylin and eosin (H&E) slides, their performances were evaluated with another 100 images.
Results
Formalin-fixed, frozen, and fresh tissues showed similar histomorphologic features in the endomicrosopic imaging. Pathologists could detect the histologic location of the images with average 65.7% accuracy and differentiate cancer tissue from normal with average 74.7% accuracy. The average sensitivity and specificity of cancer detection were 71.9% and 76.1%. The average interpretation time per image was 12.0 seconds. Following the review of matched H&E images, the accuracy of identifying the histologic location was increased to 92.8% (P<0.0001), and that of detecting cancer tissue was also increased to 90.9% (P<0.001). The sensitivity and specificity of cancer detection were enhanced to 89.1% and 93.2% (P<0.0001). The interpretation time per image was decreased to 5.3 seconds (P<0.001).
Conclusions
High-quality histologic images were immediately acquired by the confocal laser endomicroscopic system. The operator training with conventional H&E slides enabled the accurate detection of cancer and histologic location raising its potential applicability as a real-time tissue imaging modality.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.