Original InvestigationsNear Real-Time Confocal Microscopy of Amelanotic Tissue: Detection of Dysplasia in ex Vivo Cervical Tissue
Section snippets
Patients
Cervical biopsy specimens were obtained from 25 patients at the colposcopy clinics of the University of Texas M.D. Anderson Cancer Center, Herman Hospital, and Lyndon Baines Johnson Hospital in Houston, Tex. The patients had been referred to these clinics (a) because they were suspected of having dysplasia owing to abnormal findings at cervical cytologic examination or (b) for removal of the cervical tissue with the loop electrical excision procedure owing to a previous diagnosis of dysplasia.
Results
Figure 2 shows images of colposcopically normal and abnormal biopsy specimens obtained in one patient at various depths. The cell nuclei can be seen on all of the confocal images, and the cell outlines can be seen around most cells of the normal specimen. The nuclear density of the abnormal specimen is clearly increased compared with that of the normal specimen. The area of individual nuclei on the images of the abnormal specimen is also greater than that of the normal specimen. These
Discussion
Our results show that both quantitative analysis of confocal images and qualitative review by untrained observers can yield high sensitivity and specificity compared with histopathologic diagnosis. Analysis of nuclear feature measurements indicated that the nuclear-cytoplasmic ratio appears to be the most important feature for detecting dysplasia on confocal images in which the image plane is parallel to the tissue surface. The penetration depth at which images with clear intracellular features
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Supported by National Institutes of Health grant RO1 CA 82880-01.