A Research On Clinical Significance Of Confocal Laser Scanning Microscopy In Preoperative Detection Of Skin Tumor

The Research on Clinical Significance of Confocal Laser Scanning Microscopy in preoperative detection of skin tumorConfocal laser scanning microscope (CLSM) is a new high-light optical microscope in recent years, with the in-situ, real-time, dynamic three-dimensional characteristics. It ensures the cell physiological state diagnosis and real-time dynamic imaging of the same organizations repeatedly, and can reduce influence of artificial factors in the traditional production process. For CLSM with good sensitivity and specificity, it is often used in dermatologic diseases, especially skin cancer diagnosis and differential diagnosis. It also helps identify the border of the skin lesions and facilitates the assessment of extent of the operation.Most of the skin cancer occurred on the elder. The Actinic keratoses, basal cell carcinoma and squamous cell carcinoma is the common. Skin tumors are cells abnormally proliferation firstly and we can not determine the extent of skin lesions accurately with the naked eye. Mohs surgery is a skin micro-surgery Technology cooperated with frozen tissue sections. It can help us observe the characteristics of surgical specimens in time. It can ensure the integrity of a surgical cut and the tumor recurrence rate is very low. Besides it can help us reduce the area of skin damage in order to lay a good foundation for orthopedic rehabilitation. However, the high cost and long operative time limits the further development in our country. This requires us to further explore the new technology in preoperative detection of skin tumors.Our study utilized CLSM to observe the dermatic structure of basal cell epithelioma and actinic keratoses patients. Be compared with the histopathological results tumor boundaries identified, so as to provide theoretical evidence in preoperative detection of skin tumors with CLSM.Experiment was divided into three parts:The first part, to research the dermatic structure of healthy people with CLSM. The amount of volunteers was 12, whose age ranges from 41 to 73 years old, average age was 57 years old. We obtained the normal CLSM dermatic imaging from skin of forearms, compared with conventional histopathology; The second part, with CLSM to observe the dermatic structure of actinic keratoses patients and identified tumor boundaries compared with the histopathological results, statistical analysis with T test; The third part, to observe the dermatic structure of basal cell epithelioma patient with CLSM and identify tumor boundaries compared with the histopathological results.In part one, we got normal CLSM dermatic imaging successfully. In part two, observed the dermatic boundry of skin lesion of the 10 actinic keratoses patients with CLSM and compared with the histopathological results. It showed no significant difference. CLSM result was significantly lower than conventional value; In part two, observed the dermatic boundry of skin lesion of the 11 basal cell epithelioma patients with CLSM and compared with the histopathological results. It showed no significant difference. CLSM result was significantly lower than conventional value.Results:CLSM can detect tumor boundaries of the basal cell epithelioma and actinic keratoses effectively and can guide surgical resection of clinical lesions. CLSM is a real-time and non-invasive detection method. And it has broad application prospects in guiding surgical resection of skin tumors, which is worth extending forward.