Characteristics and utility of high-resolution optical coherence microscopy images of endocervical canal lesions.

May 06, 2024

Experts: Wei Zhang,Jeffrey L Fine,Xiaoyin Pei,Yushan Cao,Yixuan Liu,Jinxiang Yan,Zhenying Ban,Ting Zhang,Yuan Wei,Xin Zhao,Baojin Wang,Chengquan Zhao,Xianxu Zeng

To investigate optical coherence microscopy (OCM) imaging features and the application value of these high-resolution images for identifying endocervical canal lesions (ECLs), which is a clinical dilemma in cervical cancer screening programs.
In total, 520 OCM images were obtained by scanning the cervical canal lesions with an ultra-high-resolution OCM system (204 specimens from 73 patients). The OCM morphologic characteristics of ECLs were observed and summarized, and then 3 researchers performed a diagnostic test of OCM images of cervical canal lesions. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, 95% confidence interval of each parameter, and interinvestigator agreement (κ) were calculated.
Normal endocervix, cysts, squamous metaplasia, high-grade squamous intraepithelial lesions involving glands, and invasive carcinoma had distinct OCM characteristics, which correlated well with corresponding H&E histologic sections. The accuracy, sensitivity, and specificity of the 3 researchers were 90.6%, 89.3% (95% CI, 86.5%-91.7%) and 91.6% (95% CI, 89.2%-93.5%), respectively. The positive predictive value was 90.1% (95% CI, 87.3%-92.4%), and the negative predictive value was 90.9% (95% CI, 88.5%-92.9%), with almost perfect agreement (κ = 0.874).
The application of the OCM system in cervical canal lesions is feasible and could help improve detection of occult ECLs in cervical cancer screening programs. This study lays the foundation for further research on OCM in cervical canal lesions in vivo, which also has a potential impact on projecting pathologic evaluation beyond what is currently possible, perhaps globally.

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ABOUT THE EXPERTS

Wei Zhang,Jeffrey L Fine,Xiaoyin Pei,Yushan Cao,Yixuan Liu,Jinxiang Yan,Zhenying Ban,Ting Zhang,Yuan Wei,Xin Zhao,Baojin Wang,Chengquan Zhao,Xianxu Zeng

Wei Zhang

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Jeffrey L Fine

Department of Pathology, UPMC Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, US.

Xiaoyin Pei

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Yushan Cao

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Yixuan Liu

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Jinxiang Yan

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Zhenying Ban

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Ting Zhang

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Yuan Wei

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Xin Zhao

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Baojin Wang

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Chengquan Zhao

Department of Pathology, UPMC Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, US.

Xianxu Zeng

Department of Pathology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Radiology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

Department of Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.