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JAMA Ophthalmol:手持体内反射共聚焦显微镜用于睑缘或结膜恶性肿瘤检查

2017-06-30 zhangfan MedSci原创

手持体内反射共聚焦显微镜是有效的睑缘或结膜恶性肿瘤的鉴别方法,需进一步的研究以区分恶性黑素细胞与朗格汉斯细胞防止误诊

目前结膜和眼睑边缘肿瘤的临床诊断是极具挑战性的,需要开发新的无创成像技术。近日研究人员对手持体内反射共聚焦显微镜(IVCM)对睑缘结膜肿瘤诊断的准确性进行评估。

研究在圣艾蒂安大学医院开展,招募了278名睑缘或结膜病变患者,通过临床常规使用裂隙灯检查或IVCM对患者的结膜病变诊断,最终通过病理组织学检查排除可疑恶性并对所有患者进行12个月的裂隙灯或IVCM检查随访。主要终点是裂隙灯和手持IVCM对结膜和眼睑缘恶性肿瘤的敏感性、特异性和阳性预测值和阴性预测值。

研究招募的278名患者,其中48.9%为女性,平均年龄59岁,包含166个睑缘和129个结膜病变。对切除的155个赘生物进行组织病理学诊断发现,相比于裂隙灯检查,手持体内反射共聚焦显微镜对眼睑(98% vs 92%)以及结膜(100% vs 88%)恶性肿瘤的敏感性更高;手持体内反射共聚焦显微镜对眼睑恶性肿瘤(74% vs 46%)的特异性较高,但结膜恶性肿瘤特异性较低(78% vs 88%)。对所有的295个赘生物分析确证了上述差异。高郎格罕细胞误诊为恶性黑素细胞是造成IVCM恶性结膜肿瘤特异性低的主要原因。

研究认为手持体内反射共聚焦显微镜是有效的睑缘或结膜恶性肿瘤的鉴别方法,需进一步的研究以区分恶性黑素细胞与朗格汉斯细胞防止误诊。

原始出处:


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  1. [GetPortalCommentsPageByObjectIdResponse(id=1893775, encodeId=f2d11893e75cd, content=<a href='/topic/show?id=ab2159e343a' target=_blank style='color:#2F92EE;'>#显微镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59734, encryptionId=ab2159e343a, topicName=显微镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Sat Dec 23 00:56:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218064, encodeId=38be21806437, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Jul 03 09:06:41 CST 2017, time=2017-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541222, encodeId=88b31541222e2, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Sun Jul 02 06:56:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=217136, encodeId=cd3521e136d9, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Fri Jun 30 19:04:21 CST 2017, time=2017-06-30, status=1, ipAttribution=)]
    2017-12-23 tulenzi
  2. [GetPortalCommentsPageByObjectIdResponse(id=1893775, encodeId=f2d11893e75cd, content=<a href='/topic/show?id=ab2159e343a' target=_blank style='color:#2F92EE;'>#显微镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59734, encryptionId=ab2159e343a, topicName=显微镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Sat Dec 23 00:56:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218064, encodeId=38be21806437, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Jul 03 09:06:41 CST 2017, time=2017-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541222, encodeId=88b31541222e2, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Sun Jul 02 06:56:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=217136, encodeId=cd3521e136d9, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Fri Jun 30 19:04:21 CST 2017, time=2017-06-30, status=1, ipAttribution=)]
    2017-07-03 李东泽

    很好,不错,以后会多学习

    0

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  4. [GetPortalCommentsPageByObjectIdResponse(id=1893775, encodeId=f2d11893e75cd, content=<a href='/topic/show?id=ab2159e343a' target=_blank style='color:#2F92EE;'>#显微镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=59734, encryptionId=ab2159e343a, topicName=显微镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=54f9127, createdName=tulenzi, createdTime=Sat Dec 23 00:56:00 CST 2017, time=2017-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=218064, encodeId=38be21806437, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Jul 03 09:06:41 CST 2017, time=2017-07-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541222, encodeId=88b31541222e2, content=<a href='/topic/show?id=5c961e37307' target=_blank style='color:#2F92EE;'>#THA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17373, encryptionId=5c961e37307, topicName=THA)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=615b13300589, createdName=1249842em13(暂无昵称), createdTime=Sun Jul 02 06:56:00 CST 2017, time=2017-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=217136, encodeId=cd3521e136d9, content=学习了,谢谢, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLGSUSR8zwnWWLT4FMl5XH8S58HuZslVkLsAPbXDXaliagK7TOxQfmngKibG1yrDonepCLDkcxGk8hS/0, createdBy=b8282062892, createdName=changjiu, createdTime=Fri Jun 30 19:04:21 CST 2017, time=2017-06-30, status=1, ipAttribution=)]
    2017-06-30 changjiu

    学习了,谢谢

    0

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