Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5528_Библиотеки_им_академика_М_И_Перельмана.pdf
150 S. G. Krishna
4. Tanaka, M., Fernandez-del, Castillo. C., Adsay, V., Chari, S., Falconi, M., Jang, J. Y.,
et al. International consensus guidelines 2012 for the management of IPMN and MCN
of the pancreas. Pancreatology, 12: 183–197 (2012).
5. Park, W. G., Mascarenhas, R., Palaez-Luna, M., Smyrk, T. C., O’Kane, D., Clain, J. E.,
et al. Diagnostic performance of cyst fluid carcinoembryonic antigen and amylase in
histologically confirmed pancreatic cysts. Pancreas, 40: 42–45 (2011).
6. Valsangkar, N. P., Morales-Oyarvide, V., Thayer, S. P., Ferrone, C. R., Wargo,
J.A.,Warshaw,A.L.,et al. 851 resected cystic tumors of the pancreas: A
33-year experience at the Massachusetts General Hospital. Surgery, 52: S4–S12
(2012).
7. Gaujoux, S., Brennan, M. F., Gonen, M., D’Angelica, M. I., DeMatteo, R., Fong, Y.,
et al. Cystic lesions of the pancreas: Changes in the presentation and management
of 1,424 patients at a single institution over a 15-year time period. Journal of the
American College of Surgeons, 212: 590–600; discussion -3 (2011).
8. Scheiman, J. M., Hwang, J. H., and Moayyedi, P. American gastroenterological association technical review on the diagnosis and management of asymptomatic neoplastic
pancreatic cysts. Gastroenterology, 148: 824–848 e22 (2015).
9. Sahora, K., Mino-Kenudson, M., Brugge, W., Thayer, S. P., Ferrone, C. R., Sahani, D.,
et al. Branch duct intraductal papillary mucinous neoplasms: Does cyst size change
the tip of the scale?A critical analysisof the revised international consensus guidelines
in a large single-institutional series. Annals of Surgery, 258: 466–475 (2013).
10. Tanaka, M., Fernandez-Del, Castillo, C., Kamisawa, T., Jang, J. Y., Levy, P.,
Ohtsuka, T., et al. Revisions of international consensus Fukuoka guidelines for the
management of IPMN of the pancreas. Pancreatology, 17(5): 738–753 (2017).
11. Konda, V. J., Meining, A., Jamil, L. H., Giovannini, M., Hwang, J. H., Wallace, M. B.,
et al. A pilot study of in vivo identificationof pancreatic cystic neoplasms with needlebased confocal laser endomicroscopy under endosonographic guidance. Endoscopy,
45: 1006–1013 (2013).
12. Nakai,Y.,Iwashita,T.,Park,D.H.,Samarasena,J.B.,Lee,J.G.,andChang,K.J.Diagnosis of pancreatic cysts: EUS-guided, through-the-needle confocal laser-induced
endomicroscopy and cystoscopy trial: DETECT study. Gastrointestinal Endoscopy,
81: 1204–1214 (2015).
13. Napoleon, B., Lemaistre, A. I., Pujol, B., Caillol, F., Lucidarme, D., Bourdariat, R.,
et al. A novel approach to the diagnosis of pancreatic serous cystadenoma: Needlebased confocal laser endomicroscopy. Endoscopy, 47: 26–32 (2015).
14. Napoleon, B., Lemaistre, A. I., Pujol, B., Caillol, F., Lucidarme, D., Bourdariat, R.,
et al. In vivo characterization of pancreatic cystic lesions by needle-based confocal
laser endomicroscopy (nCLE): Proposition of a comprehensive nCLE classification
confirmed byan external retrospectiveevaluation. SurgicalEndoscopy, 30: 2603–2612
(2016).
et al.
Pancreaticobiliary System 151
15. Krishna, S. G., Brugge, W. R., Dewitt, J. M., Kongkam, P., Napoleon, B., RoblesMedranda, C., et al. Needle-based confocal laser endomicroscopy for the diagnosis
of pancreatic cystic lesions: An international external interobserver and intraobserver
study (with videos). Gastrointestinal Endoscopy, 86(4): 644–654.e2 (2017).
16. Kadayifci, A., Atar, M., Yang, M., Fernandez-Del, Castillo, C., Mino-Kenudson, M.,
and Brugge, W. R. Imaging of pancreatic cystic lesions with confocal laser endomicroscopy: An ex vivo pilot study. Surgical Endoscopy, 31(12): 5119–5126 (2017).
17. Krishna, S. G., Modi, R. M., Kamboj, A. K., Swanson, B. J., Hart, P. A., Dillhoff,
M. E., et al. In vivo and ex vivo confocal endomicroscopy of pancreatic cystic
lesions: A prospective study. World Journal of Gastroenterology, 23: 3338–3348
(2017).
18. Modi, R. M., Swanson, B., Muscarella, P., 2nd, Conwell, D. L., and Krishna, S. G.
Novel techniques for diagnosis of serous cystadenoma: Fern pattern of vascularity
confirmed by in vivo and ex vivo confocal laser endomicroscopy. Gastrointestinal
Endoscopy, 85: 258–259 (2017).
19. Krishna, S. G., Swanson, B., Hart, P. A., El-Dika, S., Walker, J. P., McCarthy, S. T.,
et al. Validation of diagnostic characteristics of needle based confocal laser endomicroscopyin differentiation of pancreatic cystic lesions.Endoscopy International Open,
4: E1124–E1135 (2016).
20. Springer, S., Wang, Y., Dal Molin, M., Masica, D. L., Jiao, Y., Kinde, I., et al. A
combination of molecular markers and clinical features improve the classification of
pancreatic cysts. Gastroenterology, 149: 1501–1510 (2015).
21. Wu, J., Jiao, Y., Dal Molin, M., Maitra, A., de Wilde R. F., Wood, L. D., et al. Wholeexome sequencing of neoplastic cysts of the pancreas reveals recurrent mutations in
components of ubiquitin-dependent pathways. Proceedings of the National Academy
of Sciences of the United States of America, 108: 21188–21193 (2011).
22. Amato, E., Molin, M. D., Mafficini, A., Yu, J., Malleo, G., Rusev, B., et al. Targeted
next-generation sequencing of cancer genes dissects the molecular profiles of intraductal papillary neoplasms of the pancreas. The Journal of pathology, 233: 217–227
(2014).
23. Banafea, O., Mghanga, F. P., Zhao, J., Zhao, R., and Zhu, L. Endoscopic ultrasonography with fine-needle aspiration for histological diagnosis of solid pancreatic masses:
A meta-analysis of diagnostic accuracy studies. BMC Gastroenterol, 16: 108 (2016).
24. Wani, S ., Mullady, D., Early, D. S., Rastogi, A., Collins, B., Wang, J. F., et al. The
clinical impact of immediate on-site cytopathology evaluation during endoscopic
ultrasound-guided fine needle aspiration of pancreatic masses: A prospective multicenter randomized controlled trial. The American Journal of Gastroenterology, 110:
1429–1439 (2015).
25. Giovannini, M. Needle-based confocal laser endomicroscopy. Endoscopic
Ultrasound, 4
: 284–288 (2015).
152 S. G. Krishna
26. Giovannini, M., Caillol, F., Poizat, F., Bories, E., Pesenti, C., Monges, G., et al. Feasibility of intratumoral confocal microscopy under endoscopic ultrasound guidance.
Endoscopic Ultrasound, 1: 80–83 (2012).
27. Hewitt, M. J., McPhail, M. J. W., Possamai, L., et al. EUS-guided FNA for diagnosis
of solid pancreatic neoplasms: A meta-analysis. Gastrointestinal Endoscopy, 75: 319–
331 (2012).
28. Karstensen, J. G., Câr¸tân˘a, T., Klausen, P. H., Hassan, H., Popescu, C. F., S˘aftoiu, A.,
et al. Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy: A
pilot study for use in focal pancreatic masses. Pancreas, 44: 833–835 (2015).
29. Kongkam, P., Pittayanon, R., Sampatanukul, P., Angsuwatcharakon, P., Aniwan, S.,
Prueksapanich, P., et al. Endoscopic ultrasound-guided needle-based confocal laser
endomicroscopy for diagnosis of solid pancreatic lesions (ENES): A pilot study.
Endoscopy International Open, 4: E17–E23 (2016).
30. Khan, S. A., Thomas, H. C., Davidson, B. R., and Taylor-Robinson, S. D. Cholangiocarcinoma. Lancet, 366: 1303–1314 (2005).
31. Loeser, C. S., Robert, M. E., Mennone, A., Nathanson, M. H., and Jamidar, P. Confocal
endomicroscopic examination of malignant biliary strictures and histologic correlation
with lymphatics. Journal of Clinical Gastroenterology, 45: 246–252 (2011).
32. Navaneethan, U., Njei, B., Lourdusamy, V., Konjeti, R., Vargo, J. J., and Parsi, M.
A. Comparative effectiveness of biliary brush cytology and intraductal biopsy for
detection of malignant biliary strictures: A systematic review and meta-analysis. Gas-
trointestinal Endoscopy, 81: 168–176 (2015).
33. Charbel, H., and Al-Kawas, F. H. Cholangiocarcinoma: Epidemiology, risk factors,
pathogenesis, and diagnosis. Current Gastroenterology Reports, 13: 182–187 (2011).
34. Cheon, Y. K. The role of photodynamic therapy for hilar cholangiocarcinoma. The
Korean Journal of Internal Medicine, 25: 345–352 (2010).
35. Slivka, A., Gan, I., Jamidar, P., Costamagna, G., Cesaro, P., Giovannini, M., et al,
Validation of the diagnostic accuracy of probe-based confocal laser endomicroscopy
for the characterization of indeterminate biliary strictures: Results of a prospective
multicenter international study. Gastrointestinal Endoscopy, 81: 282–290 (2015).
36. Ruys, A. T., van Haelst, S., Busch, O. R., Rauws, E. A., Gouma, D. J., and van Gulik,
T. M. Long-term survival in hilar cholangiocarcinoma also possible in unresectable
patients. World Journal of Surgery, 36: 2179–2186 (2012).
37. Gerhards, M. F., Vos, P., van Gulik, T. M., Rauws, E. A., Bosma, A., and Gouma,
D. J. Incidence of benign lesions in patients resected for suspicious hilar obstruction.
British Journal of Surgery, 88: 48–51 (2001).
38. Caillol, F., Bories, E., Autret, A., Poizat, F., Pesenti, C., Ewald, J., et al. Evaluation of
pCLE in the bile duct: Final results of EMID study: pCLE: Impact in the management
of bile duct strictures. Surgical Endoscopy
et al.
, 29: 2661–2668 (2015).
Pancreaticobiliary System 153
39. Rösch, T., Hofrichter, K., Frimberger, E., Meining, A., Born, P., Weigert, N., et al.
ERCP or EUS for tissue diagnosis of biliary strictures? A prospective comparative
study. Gastrointestinal Endoscopy, 60: 390–396 (2004).
40. Karia, K., and Kahaleh, M. A review of probe-based confocal laser endomicroscopy
for pancreaticobiliary disease. Clinical Endoscopy, 49: 462–466 (2016).
41. Kahaleh,M., Giovannini,M., Jamidar,P., Gan, S. I., Cesaro, P.,Caillol, F., et al. Probebased confocal laser endomicroscopy for indeterminate biliary strictures: Refinement
of the image interpretation classification. Gastroenterology Research and Practice,
2015: 675210 (2015).
42. Shah, R. J., Langer, D. A., Antillon, M. R., and Chen, Y. K. Cholangioscopy and
cholangioscopic forceps biopsy in patients with indeterminate pancreaticobiliary
pathology. Clinical Gastroenterology and Hepatology, 4: 219–225 (2006).
43. Boberg, K. M., Lind, G. E. Primary sclerosing cholangitis and malignancy. Best Prac-
tice and Research in Clinical Gastroenterology, 25: 753–764 (2011).
44. Heif, M., Yen, R. D., and Shah, R. J. ERCP with probe-based confocal laser endomicroscopy for the evaluation of dominant biliary stenoses in primary sclerosing cholangitis patients. Digestive Diseases and Sciences, 58: 2068–2074 (2013).
45. Wallace, M., Lauwers, G. Y., Chen, Y., Dekker, E., Fockens, P., Sharma, P., et al.
Miami classification for probe-based confocal laser endomicroscopy. Endoscopy, 43:
882–8891 (2011).
46. Wallace, M. B., and Fockens, P. Probe-based confocal laser endomicroscopy.
Gastroenterology, 136: 1509–1513 (2009).
47. Meining, A., Chen, Y. K., Pleskow, D., Stevens, P., Shah, R. J., Chuttani, R., et al. Direct
visualization of indeterminate pancreaticobiliary strictures with probe-based confocal
laser endomicroscopy: A multicenter experience. Gastrointestinal Endoscopy, 74:
961–968 (2011).
48. Meining, A., Shah, R. J., Slivka, A., Pleskow, D., Chuttani, R., Stevens, P. D., et al.
Classification of probe-based confocal laser endomicroscopy findings in pancreaticobiliary strictures. Endoscopy, 44: 251–257 (2012).
49. Tabibian, J. H., Visrodia, K. H., Levy, M. J., and Gostout, C. J. Advanced endoscopic imaging of indeterminate biliary strictures. World Journal of Gastrointestinal
Endoscopy, 7: 1268–1278 (2015).
50. Meining, A., Frimberger, E., Becker, V., Von Delius, S., V on Weyhern, C. H., Schmid,
R. M., et al. Detection of cholangiocarcinoma in vivo using miniprobe-based confocal
fluorescence microscopy. Clinical Gastroenterology and Hepatology, 6: 1057–1060
(2008).
51. Giovannini, M., Bories, E., Monges, G., Pesenti, C., Caillol, F., and Delpero, J. R.
Results of a phase I-II study on intraductal confocal microscopy (IDCM) in patients
with common bile duct (CBD) stenosis. Surgical Endoscopy, 25: 2247–2253 (2011).
154 S. G. Krishna
52. Caillol, F., F iloche, B., Gaidhane, M., and Kahaleh, M. Refined probe-based confocal laser endomicroscopy classification for biliary strictures: The Paris classification.
Digestive Diseases and Sciences, 58: 1784–1789 (2013).
53. Löhr, J. M., Lönnebro, R., Stigliano, S., Haas, S. L., Swahn, F., Enochsson,
L., et al. Outcome of probe-based confocal laser endomicroscopy (pCLE) during
endoscopic retrograde cholangiopancreatography: A single-center prospective study
in 45 patients. United European Gastroenterology Journal, 3: 551–560 (2015).
54. Fugazza, A., Gaiani, F., Carra, M. C., Brunetti, F., Lévy, M., Sobhani, I., et al. Confocal
laser endomicroscopy in gastrointestinal and pancreatobiliary diseases: A systematic
review and meta-analysis. BioMed Research International, 2016 (2016).
55. Liu, Y., Lu, Y., Sun, B., Zhang, W. M., Zhang, Z. Z., He, Y. P., et al. Probe-based
confocal laser endomicroscopy for the diagnosis of undetermined biliary stenoses: A
meta-analysis. Clinics and Research in Hepatology and Gastroenterology, 40: 666–
673 (2016).
56. Wang, K. K., Carr-Locke, D. L., Singh, S. K., Neumann, H., Bertani, H., Galmiche,
J. P., et al. Use of probe-based confocal laser endomicroscopy (pCLE) in gastrointestinal applications. A consensus report based on clinical evidence. United European
Gastroenterology Journal, 3: 230–254 (2015).
57. Anderson, M. A., Appalaneni, V., Ben-Menachem, T., Decker, G. A., Early, D. S.,
Evans, J. A., et al. The role of endoscopy in the evaluation and treatment of patients
with biliary neoplasia. Gastrointestinal Endoscopy, 77: 167–174 (2013).
58. Almadi, M. A., and Neumann, H. Probe based confocal laser endomicroscopy of
the pancreatobiliary system. World Journal of Gastroenterology, 21: 12696–12708
(2015).
et al.
© 2024 World Scientific Publishing Company
https://doi.org/10.1142/9789813206984_0008
Lungs Chapter
8
Manu Jain∗, Carolyn Glass†,
Nasser K. Altorki
Introduction
‡
, and Navneet Narula
§
Lung cancer is the most common cause of cancer-related mortality worldwide in both men and women. According to the American Cancer Society
annual report, it is estimated that in 2018 there would be 234,030 new cases
of lung cancer and 154,050 deaths in the United States.
of cases are due to long-term tobacco smoking but about 20% of cases occur
in never smokers. The 5-year survival for patients with non-small-cell lung
cancer (NSCLC) is dependent on stage: being 92% for Stage 1A and 10%
for stage IV.
∗
Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY,
USA.
†
Department of Pathology, Duke University Medical Center, Durham, NC, USA.
‡
Department of Thoracic Surgery, Weill Cornell Medical College, New York, NY, USA.
§
Department of Pathology, NYU School of Medicine, New York, NY, USA.
2
155
1
The vast majority
156 M. Jain
et al.
Chest radiography and computed tomography imaging a re initially
used to detect lung tumors, but definitive diagnosis requires pathologic
examinationusing hematoxylin and eosin (H&E)stained tissue withadjunct
immunohistochemical analysis. Here we discuss the use of alternative,
rapid optical imaging techniques that provide morphological details such as
full-fieldoptical coherence tomography (FFOCT), multiphotonmicroscopy
(MPM), and fluorescence confocal microscopy (FCM) for diagnosing neoplastic and possibly, non-neoplastic lung disease in ex vivo tissues.
3–5
We
will also briefly discuss the use of some of these aforementioned ex vivo
optical imaging techniques for in vivo imaging with focus on techniques
such as optical coherence tomography (OCT) and probe-based confocal
laser endomicroscopy (pCLE) that have been tested for real-time in vivo
imaging of lung in humans.
6–10
Principle of optical imaging techniques
The technical details of FFOCT, MPM, and FCM technology are detailed
in previous publications.
3–5,11, 12
Briefly, FFOCT is based on the principle
of white-light interference microscopy. When a biological tissue is placed
under the objective, the light reflected by the reference mirror interferes
with the light reflected or backscattered by the sample structures contained
in a limited volume. Interference only occurs when optical path lengths of
the two interferometer arms are identical, within ∼1 µm. Whereas, MPM
relies on the simultaneous absorption of 2 or 3 low-energy photons to cause
a nonlinear excitation, using 2-photon excitation in the 700–800 nm range
and second harmonic generation signal (SHG). FCM system uses a diode
laser and excites tissue at 488 nm wavelength, providing a lateral resolution
of 1.0 µm (cellular resolution images). The advantage of FCM over MPM
is the ability to image a large tissue piece (by a process of mosaicking) measuring approximately ∼1 cm within few seconds. However, unlike FFOCT
and MPM, FCM requires tissue staining using nuclear dye, such as acridine
orange.
FFOCT, MPM, and FCM enable ex vivo imaging of fresh, unprocessed, and unstained tissue at “near-histologic” resolution in real time.
Aptly, these emerging techniques are collectivelycalled as “optical-biopsy”
tools. When coupled withthoracoscopic technology,such techniques would
Lungs 157
allow in vivo visualization of suspicious lung lesions at cellular and subcellular levels. Accurately diagnosing the lesion in vivo in real time could
potentially allow resection of only the pathologic lesions, prevent unnecessary benign excisional biopsies and resections, reduce sampling error, and
ultimately minimize patient morbidity. In fact, there are two such promising real-time high-resolution imaging techniques that have been used for
in vivo imaging of human lungs: OCT and pCLE.
6–10
Both the techniques
use probes that can be inserted through the working channel of the bronchoscope into the airway for imaging. OCT uses near-infrared light to create
large field of view (FOV) cross-sectional images by the backscattering of
light from the tissue without the use of any exogenous dye or contrast
6–8
agent.
pCLE, on the other hand, uses the principle of fluorescence con-
focal microscopy where a fluorophore such as methylene blue is used for
9,10
the visualization of tissue.
The tissue is excited using 488 nm or 660 nm
laser light to create “quasi-histology” images with a lateral resolution of
3 microns, however, unlike OCT, the FOV of 600 microns is relatively
small.
Role of ex vivo optical imaging techniques in lung cancer
The ability to visualize fresh, unprocessedtissue at a “quasi-histologic” resolution potentially allows for these optical techniques during intraoperative
consultation as an alternative or adjunct to frozen section analysis. Lung
specimens can comprise a high percentage of intraoperative frozen section
consultations. Currently, frozen section analysis requires embedding tissue
in OCT medium, sectioning, and staining, which usually takes 10–20 min
before a diagnosis can be rendered to the surgeon.
13,14
Moreover, critical tissue can be lost during processing which may become problematic
in limited samples. Assessing parenchymal resection margins in real time
to confirm negative margins would potentially allow for more sublobar
resections. This would be especially valuable in patients with underlying
non-neoplastic lung disease with poor reserve. Because imaging data are
digital, they can be “streamed” to remote pathologists for expert consultation, without the pathologist being present at the procedure site. Furthermore, during biopsy procedure, these techniques can be used to improve
158 M. Jain
et al.
the yield of diagnostic tissue for histopathological evaluation, such as by
avoiding areas with fibrosis or necrosis and thus minimizing unnecessary
repeat biopsies at a later date.
The discovery of targetable driver mutations specifically in patients
with adenocarcinoma has led to additional procedures to obtain tumor tissue
for molecular testing.
15,16
It is thus critical in these cases, to be able to target
and thus biopsy in real time, only tumor tissue during the bronchoscopy or
other relevant procedures.
FFOCT, MPM, and FCM can identify normal ex vivo lung tissue
FFOCT, MPM, and FCM have recently been shown to identify normal
histology of a human lung in fresh ex vivo unprocessed and unstained tis-
3–5
sues.
The lung parenchyma (Figure 1(a, c)) appears as a lace-like structure composed of alveoli (dark signal-void areas) surrounded by bright pleura (connective tissue-bright signal). The bronchus (Figure 1(e)) appears as a dark
(signal-void) round to oval structure lined by columnar epithelium (gray
signal from cell cytoplasm and dark round nucleus) and can be differentiated from other dark round to oval structures such as blood vessels (Figure
1(c)) by a lack of epithelial lining in the latter.
fresh unprocessed ex vivo tissues. Images a through d show the characteristic lace-like pattern of lung parenchyma formed by alveoli, a long with
the surrounding pleura. In addition to FFOCT, MPM can further differentiate signals from collagen type I/III (SHG signal; color-coded red) and
elastin (autofluorescence signal; color-coded green). For example, elastin
component (autofluorescence signal; color-coded green) is prominent in
the alveolar septa (Figure 2(c)); whereas, the visceral pleura rich in collagen has mainly SHG signal (color-coded red) (Figure 2(a), inset). The
bronchus (Figure 2(e, h)) lined by ciliated columnar epithelium (autofluorescence signal from cell cytoplasm; color-coded green and dark nucleus)
with associated cartilage and a medium-sized blood vessel is also highlighted. Furthermore, various layers of a blood vessel (Figure 2(e, f)) can be
delineated with MPM. Medial smooth muscle layer with autofluorescence
Figure 1 shows various normal structures as they appearon FFOCT.
Figure 2 shows the normal architecture of a lung as seen on MPM in
Lungs 159
(a) (b)
(c) (d)
(e) (f)
Figure 1. Comparative full-field optical coherence tomography (FFOCT) and H&E images of nonneoplastic lung. (a, b) Large-field images show lung parenchyma composed of alveoli (signal void
areas; arrows) surrounded by pleura (connective tissue-bright signals; arrowheads). Some thickening
of the alveolar septa is shown (right arrow). (c, d) Images of blood vessels (arrowheads) and surrounding alveoli (arrows). (e, f) Images of a bronchus, with columnar epithelial lining (box and inset)
and underlying connective tissues (connective tissue-bright signal). (Scale bars for FFOCT: (a) 1 mm;
(c, e) 0.5mm. Inset in (e) 0.1 mm. H&E total magnifications: (b) × 40 and (d, f) × 200. Inset in (f) =×
2.5 zoom). Figure reproduced with permission, courtesy of the Journal of Pathology Informatics.
3