Features of oral squamous cell carcinoma in ex vivo fluorescence confocal microscopy

Abstract

Background Real‐time microscopic imaging of freshly excised oral squamous cell carcinomas (OSCCs) would be potentially supportive in rapid recognition of oral malignancy and an optimal and time‐saving management of patients' surgical treatment. Objectives The aim of this study was to examine oral squamous cell cancer tissue in regards to the commonly known and well‐described histomorphologic criteria for the diagnosis of OSCC in ex vivo confocal fluorescent microscopy and to analyze its correlation with grade of differentiation and level of invasiveness. Methods Ex vivo confocal laser scanning microscopy (CLSM) images of 38 OSCCs were evaluated immediately after excision for presence or absence of various cytological and architectural features based on the histopathological background. Next, these features were compared to the grade of differentiation as elaborated via gold standard histologic examination. Results Of 38 invasive OSCCs, 14 were well differentiated, while three moderately and 19 were poorly differentiated. The presence of the commonly known cytologic and histopathologic criteria for the diagnosis of oral squamous cell carcinoma such as the destruction of the basal cell membrane, cellular and nuclear pleomorphism, anisocytosis, intraepithelial keratinization, nuclear hyperchromasia, atypical mitotic figures as well as the presence of necrosis, and mixed inflammation could be observed in ex vivo fluorescence confocal microscopy (FCM). In ex vivo fluorescence confocal microscopy pictures, cellular pleomorphism and anisocytosis were observed more often in poorly differentiated OSCCs. Intraepithelial keratinization was associated with well differentiated and moderately differentiated OSCCs. Conclusion The results demonstrate the high potential of ex vivo fluorescence confocal microscopy in fresh tissue for rapid real‐time diagnosis of OSCC.

Ex vivo fluorescent confocal microscopy images of oral mucosa: Tissue atlas and evaluation of the learning curve

“…These features could also be observed in the obtained ex vivo FCM images, as described in previous studies of our workgroup [11,12].…”

“…In our previous works, we assessed the accuracy of this novel technology and reported a sensitivity of 0.991, specificity of 0.9527 for the detection of OSCC [11]. Moreover, benign and inflammatory changes were well recognizable.…”

“…Several investigations aimed to introduce technologies for immediate intraoperative or bed-side pathological examination of oral mucosa tissue, including frozen section, light reflectance spectroscopy, multiphoton microscopy, confocal laser endomicroscopy, and others. In our previous works [11,12], we described the features of oral squamous cell carcinoma (OSCC) in ex vivo FCM. Although histopathology is considered the gold standard for diagnosing benign and malignant lesions of the oral mucosa, there is an increased interest in real-time, bed-or chair-side, or even intraoperative pathological tissue examination during biopsies or cancer surgeries.…”

Negative regulation of miR‐1288‐3p/KRT4 axis through a circular RNA in oral cancer

“…[ 2 ] Recently, despite encouraging progress in the prevention, detection, and treatment of OSCC, it is disappointing that the overall 5‐year survival rate for OSCC remains low at its best. [ 3,4 ] In addition, screening and early detection are thought to reduce the morbidity and mortality of OSCC, and there are no clear criteria for predicting the risk of a single oral precancerous lesion. [ 5 ] Therefore, there is an urgent need to develop valuable molecular markers for the screening and diagnosis of OSCC.…”

Deep Learning on Oral Squamous Cell Carcinoma Ex Vivo Fluorescent Confocal Microscopy Data: A Feasibility Study

“…Ex vivo fluorescent confocal microscopy (FCM) is a novel technology successfully applied for tissue visualization in cellular resolution on the breast, prostate, brain, thyroid, esophagus, stomach, colon, lung, lymph node, cervix, and larynx [3][4][5][6]. Furthermore, our working group recently provided a number of works showing high agreement of confocal images with histopathological sections [7]. Chair-side, bed-side, or intraoperative application is one interesting field of application for this technology.…”