利用非線性光學顯微術鑑別基底細胞癌與其周圍正常組織及作為手術切除引導之可行性

Abstract

基底細胞癌是一種常見的皮膚癌，它發生的機制是因為皮膚長期曝曬於陽光中並受紫外線照射而導致基底細胞的病變以演變成癌細胞，好發於面部與頸部。由於該種癌復發率極高，所以傳統手術上會擴大腫瘤切除範圍，然而若腫瘤發生於眼、耳、鼻、口等面部邊界，或腫瘤面積大於直徑20 mm等情況，通常在臨床上會使用Mohs手術切除基底細胞癌腫瘤。該法係將所切除之組織邊緣於手術時，同時進行病理切片，用以確定是否將癌症組織徹底切除乾淨。雖然該法相較傳統的外科手術而言，更能有效的降低日後癌症的復發率，但是卻仍需要經過切片、固定、染色等傳統的病理切片手續。而我們本篇論文所論述者是期望可以利用多光子顯微術以取代傳統的病理切片，當作手術切除時的即時導引工具。雙光子螢光倍頻顯微術係一種非線性光學顯微技術，具有低侵入性、低光破壞性、高度光解析度並且較傳統切片方法更具即時性。在我的研究中，利用自行架構的多光子顯微鏡於基底細胞癌組織中，取得自發螢光與二倍頻影像，並且試圖建立一套用以定量及判別基底細胞癌及其周圍正常組織的標準依據，進而希望能作為完全切除癌細胞手術的引導技術。

Basal cell carcinoma is the most common skin cancer in the oriental population. It usually develops in the sun-exposed skin. Conventionally, the cancer is removed by wide excision, aimed at preventing local recurrence. When a wide safety margin can not be obtained in areas including eyelids, periorbital area and nasal alae, Mohs’ surgery is employed to ensure complete elimination of cancer cells while preserving these anatomically important structures. However, it takes time for tissue processing for microscopical examination. In this work, we use multiphoton fluorescence and second harmonic generation microscope to examine basal cell carcinoma specimens. The autofluorescence and second harmonic generation signals are compared with routine histological examinations using H&E staining. Our results show that cancer cells and caner stroma can be differentiated from the adjacent normal skin using multiphoton fluorescence and second harmonic generation microscopy.