DISTINGUISHING BETWEEN HYPERPLASTIC AND ADENOMATOUS POLYPS AND NORMAL COLONIC MUCOSA BY USING MULTIPHOTON LASER SCANNING MICROSCOPY

Hongsheng Li,Jianxin Chen,Changyin Feng,Xiaoqin Zhu,Guoxian Guan,Yinghong Yang,Weizhong Jiang,Shuangmu Zhuo,Zhifen Chen

doi:10.1142/s1793545813500569

Hongsheng Li, Jianxin Chen + Show 7 more

Open Access

https://doi.org/10.1142/s1793545813500569

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Abstract

Precisely distinguishing between hyperplastic and adenomatous polyps and normal human colonic mucosa at the cellular level is of great medical significance. In this work, multiphoton laser scanning microscopy (MPLSM) was used to obtain the high-contrast images and the morphological characteristics from normal colonic mucosa, hyperplastic polyps and tubular adenoma. By integrating the length and area measurement tools and computing tool, we quantified the difference of crypt morphology and the alteration of nuclei in normal and diseased human colonic mucosa. Our results demonstrated that the morphology of crypts had an obvious tendency to cystic dilatation or elongated in hyperplastic polyps and tubular adenoma. The content and number of mucin droplets of the scattered goblet cells had a piecemeal reduction in hyperplastic polyps and a large decrease in tubular adenoma. The nuclei of epithelial cells might be elongated and pseudostratified, but overt dysplasia was absent in hyperplastic polyps. Nevertheless, the nuclei showed enlarged, crowded, stratified and a rod-like structure, with loss of polarity in tubular adenoma. These results suggest that MPLSM has the capacity to distinguish between hyperplastic and adenomatous polyps and normal human colonic mucosa at the cellular level.

Highlights

Colonic cancer is the fourth most common cancer in men and the third most common cancer in women worldwide.[1]
We study normal, hyperplastic and adenomatous colonic mucosa and focus on the alterations of crypt and epithelial cell by using multiphoton laser scanning microscopy (MPLSM) based on second harmonic generation (SHG) and two-photon excited °uorescence (TPEF)
SHG signals originate from collagenber with noncentrosymmetric structure

Summary

Introduction

Colonic cancer is the fourth most common cancer in men and the third most common cancer in women worldwide.[1]. Probing the alterations in normal and diseased tissues and performing real-time histology or virtual biopsy for the diagnosis of colonic cancer is of great medical signicance Imaging approaches such as chromoendoscopy, high resolution and magnication endoscopy, narrow band imaging and auto-°uorescence imaging improve the visualization and detection of mucosal lesions, histologic examination of the targeted lesion remains the gold standard for a denitive diagnosis.[5] Gastroenterologists still rely on the results of histological diagnosis.[6] it is questionable that nonrepresentative biopsies may miss relevant portions of tissue, leading to underestimation of the diagnosis and a much higher risk for the patients.[7] with resection of benign lesions or suspicious areas, the standard approach results in a large proportion of unnecessary polypectomies, which increases time, risk and cost of colonoscopy with unnecessary follow-up.[8] today's challenge for new imaging technology is to observe morphological and pathological characteristics in normal and diseased tissues and perform real-time histology or virtual biopsy in colonic mucosal layer

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