Abstract
BackgroundEarly gastric cancer is associated with a much better prognosis than advanced disease, and strategies to improve prognosis is strictly dependent on earlier detection and accurate diagnosis. Therefore, a label-free, non-invasive imaging technique that allows the precise identification of morphologic changes in early gastric cancer would be of considerable clinical interest.MethodsIn this study, multiphoton microscopy (MPM) using two-photon excited fluorescence combined with second-harmonic generation was used for the identification of early gastric cancer.ResultsThis microscope was able to directly reveal improved cellular detail and stromal changes during the development of early gastric cancer. Furthermore, two features were quantified from MPM images to assess the cell change in size and stromal collagen change as gastric lesion developed from normal to early cancer.ConclusionsThese results clearly show that multiphoton microscopy can be used to examine early gastric cancer at the cellular level without the need for exogenous contrast agents. This study would be helpful for early diagnosis and treatment of gastric cancer, and may provide the groundwork for further exploration into the application of multiphoton microscopy in clinical practice.
Highlights
Gastric cancer is associated with a much better prognosis than advanced disease, and strategies to improve prognosis is strictly dependent on earlier detection and accurate diagnosis
The prognosis for early gastric cancer is universally excellent, and strategies to improve prognosis is strictly dependent on earlier detection and accurate diagnosis since early gastric cancer can potentially be cured by endoscopic therapy such as endoscopic mucosal resection
In this study, we investigated the potential of using label-free, multimodal multiphoton microscopy that incorporates two-photon excited fluorescence and second-harmonic generation techniques for distinguishing early gastric cancer from normal tissues
Summary
Gastric cancer is associated with a much better prognosis than advanced disease, and strategies to improve prognosis is strictly dependent on earlier detection and accurate diagnosis. The prognosis for early gastric cancer is universally excellent, and strategies to improve prognosis is strictly dependent on earlier detection and accurate diagnosis since early gastric cancer can potentially be cured by endoscopic therapy such as endoscopic mucosal resection. Multiphoton imaging technique such as two-photon excitation fluorescence (TPEF) and second-harmonic generation (SHG) has been widely used for biological tissue imaging [8, 9]. In this study, we investigated the potential of using label-free, multimodal multiphoton microscopy that incorporates two-photon excited fluorescence and second-harmonic generation techniques for distinguishing early gastric cancer from normal tissues. Two investigators who were blinded to the diagnostic results confirmed all the multiphoton imaging results by comparing with the H&E-stained digital images
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