Prospection of optical coherence tomography for determining the tumor invasive front of hilar cholangiocarcinoma / 中国实用外科杂志

ABSTRACT

OBJECTIVE: To explore the feasibility of using optical coherence tomography(OCT)technique to determine the tumor invasive front of hepatic hilar cholangiocarcinoma.METHODS: Two patients were diagnosed in Beijing Tsinghua Changgung Hospital as type Bismuth Ⅳ and type Ⅲ b hilar cholangiocarcinoma respectively and both underwent perihilar and left trihepatectomy.The common bile duct-common hepatic duct,right anterior hepatic duct and left hepatic duct were all opened along the axial direction of the bile duct after the two specimens were excised.OCT equipment was used to scan the three branches to determine the dividing point between cancer and normal bile duct.Suture markers were performed of the 6 positions,and pathological examination was carried out.RESULTS: Pathologically,both 2 cases were confirmed as hilar cholangiocarcinoma.Under OCT scan,normal bile ducts showed the inner single layer of epithelial cells was visible as a superficial,hypo-reflective layer.The intermediate connective fibromuscular layer was visible as a hyper-reflective layer and the outer connective layer was visible as a hypo-reflective layer.Malignancies showed unrecognizable layer architecture and multiple presence of nonreflective areas,with or without papillary architecture.Among 6 marker-positions determined by OCT in the 2 specimens,4 sites were less than 1 mm,1 site was about 2 mm and 1 site was about 7 mm apart from pathological tumor invasive front.CONCLUSION: OCT as a fast-real-time imaging technique has the potential to determine the tumor invasive front of hilar cholangiocarcinoma.