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Detection of morphologic alterations in rectal carcinoma following preoperative radiochemotherapy based on multiphoton microscopy imaging.

Li L, Chen Z, Wang X, Li H, Jiang W, Zhuo S, Guan G, Chen J - BMC Cancer (2015)

Bottom Line: Preoperative radiochemotherapy improves outcomes in patients with locally advanced rectal carcinoma, and has been used increasingly in patient management.In this study, we used multiphoton microscopy (MPM) to detect morphologic alterations in rectal adenocarcinomas in patients treated with preoperative radiochemotherapy.MPM was able to identify histopathologic alterations in rectal cancer following preoperative radiochemotherapy, and allowed the qualitative assessment of treatment efficacy and feasibility in relation to dose or strategy.

View Article: PubMed Central - PubMed

Affiliation: Institute of Laser and Optoelectronics Technology, Fujian Provincial Key Laboratory for Photonics Technology, Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Normal University, Fuzhou, 350007, China. lhli@fjnu.edu.cn.

ABSTRACT

Background: Preoperative radiochemotherapy improves outcomes in patients with locally advanced rectal carcinoma, and has been used increasingly in patient management. However, there is a strong clinical need to assess tumor response to neoadjuvant treatment, and a non-invasive technique that allows the precise identification of morphologic changes in tumors would be of considerable clinical interest.

Methods: In this study, we used multiphoton microscopy (MPM) to detect morphologic alterations in rectal adenocarcinomas in patients treated with preoperative radiochemotherapy.

Results: MPM was able to identify histopathologic alterations in rectal cancer following preoperative radiochemotherapy, and allowed the qualitative assessment of treatment efficacy and feasibility in relation to dose or strategy.

Conclusion: These findings may provide the groundwork for evaluating tumor response to neoadjuvant treatment, thus allowing the tailoring of effective treatment doses and strategies.

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Related in: MedlinePlus

Representative TPEF/SHG images of residual tumors surrounded by fibrosis with minimal inflammatory cells. Scale bar = 100 μm. (a) SHG image (green); (b) TPEF image (red); (c) overlay of SHG/TPEF images; and (d) corresponding H&E-stained image (40× magnification).
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Fig3: Representative TPEF/SHG images of residual tumors surrounded by fibrosis with minimal inflammatory cells. Scale bar = 100 μm. (a) SHG image (green); (b) TPEF image (red); (c) overlay of SHG/TPEF images; and (d) corresponding H&E-stained image (40× magnification).

Mentions: MPM and H&E-stained images showed residual tumors in the muscularis propria after preoperative radiochemotherapy (Figure 3). Tumor cells in the rectal carcinoma may show marked posttreatment changes, such as nuclear atypia, and these altered tumor cells may retain a glandular growth pattern or become more solid [15,16]. In the current study, the dominant tumor morphologic pattern remained similar in treated and untreated rectal adenocarcinomas (white arrows); the tumors were surrounded by fibrosis with minimal inflammatory cells, while some tumor cells became solid (blue arrow). Furthermore, MPM allowed the differentiation of cellular features such as nuclear pleomorphism, which is an important biologic characteristic reflecting tumor grade, degree of differentiation, and proliferation. The region of interest within the white box in Figure 3(c) is magnified in Figure 4 to show the ultrastructure of the residual cancerous cells more clearly. These alterations following preoperative radiochemotherapy are common and might be clinically meaningful. The details of the morphological changes revealed by MPM correlated well with those shown in H&E-stained images (Figure 3(d)).Figure 3


Detection of morphologic alterations in rectal carcinoma following preoperative radiochemotherapy based on multiphoton microscopy imaging.

Li L, Chen Z, Wang X, Li H, Jiang W, Zhuo S, Guan G, Chen J - BMC Cancer (2015)

Representative TPEF/SHG images of residual tumors surrounded by fibrosis with minimal inflammatory cells. Scale bar = 100 μm. (a) SHG image (green); (b) TPEF image (red); (c) overlay of SHG/TPEF images; and (d) corresponding H&E-stained image (40× magnification).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4373096&req=5

Fig3: Representative TPEF/SHG images of residual tumors surrounded by fibrosis with minimal inflammatory cells. Scale bar = 100 μm. (a) SHG image (green); (b) TPEF image (red); (c) overlay of SHG/TPEF images; and (d) corresponding H&E-stained image (40× magnification).
Mentions: MPM and H&E-stained images showed residual tumors in the muscularis propria after preoperative radiochemotherapy (Figure 3). Tumor cells in the rectal carcinoma may show marked posttreatment changes, such as nuclear atypia, and these altered tumor cells may retain a glandular growth pattern or become more solid [15,16]. In the current study, the dominant tumor morphologic pattern remained similar in treated and untreated rectal adenocarcinomas (white arrows); the tumors were surrounded by fibrosis with minimal inflammatory cells, while some tumor cells became solid (blue arrow). Furthermore, MPM allowed the differentiation of cellular features such as nuclear pleomorphism, which is an important biologic characteristic reflecting tumor grade, degree of differentiation, and proliferation. The region of interest within the white box in Figure 3(c) is magnified in Figure 4 to show the ultrastructure of the residual cancerous cells more clearly. These alterations following preoperative radiochemotherapy are common and might be clinically meaningful. The details of the morphological changes revealed by MPM correlated well with those shown in H&E-stained images (Figure 3(d)).Figure 3

Bottom Line: Preoperative radiochemotherapy improves outcomes in patients with locally advanced rectal carcinoma, and has been used increasingly in patient management.In this study, we used multiphoton microscopy (MPM) to detect morphologic alterations in rectal adenocarcinomas in patients treated with preoperative radiochemotherapy.MPM was able to identify histopathologic alterations in rectal cancer following preoperative radiochemotherapy, and allowed the qualitative assessment of treatment efficacy and feasibility in relation to dose or strategy.

View Article: PubMed Central - PubMed

Affiliation: Institute of Laser and Optoelectronics Technology, Fujian Provincial Key Laboratory for Photonics Technology, Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education, Fujian Normal University, Fuzhou, 350007, China. lhli@fjnu.edu.cn.

ABSTRACT

Background: Preoperative radiochemotherapy improves outcomes in patients with locally advanced rectal carcinoma, and has been used increasingly in patient management. However, there is a strong clinical need to assess tumor response to neoadjuvant treatment, and a non-invasive technique that allows the precise identification of morphologic changes in tumors would be of considerable clinical interest.

Methods: In this study, we used multiphoton microscopy (MPM) to detect morphologic alterations in rectal adenocarcinomas in patients treated with preoperative radiochemotherapy.

Results: MPM was able to identify histopathologic alterations in rectal cancer following preoperative radiochemotherapy, and allowed the qualitative assessment of treatment efficacy and feasibility in relation to dose or strategy.

Conclusion: These findings may provide the groundwork for evaluating tumor response to neoadjuvant treatment, thus allowing the tailoring of effective treatment doses and strategies.

Show MeSH
Related in: MedlinePlus