Background: Colorectal cancer screening programs have accomplished a mortality reduction from the disease but have created bottlenecks in endoscopy units and pathology departments. We aimed to explore the feasibility of ex vivo fusion confocal microscopy (FuCM) to improve the histopathology diagnostic efficiency and reduce laboratory workload. Methods: Consecutive fresh polyps removed at colonoscopy were scanned using ex vivo FuCM, then went through histopathologic workout and hematoxylin and eosin (Hamp;E) diagnosis. Two pathologists blinded to Hamp;E diagnosis made a diagnosis based on FuCM scanned images. Results: Thirty-six fresh polyps from 22 patients were diagnosed with FuCM and Hamp;E. Diagnostic agreement between Hamp;E and FuCM was 97.2% (kappa = 0.96) for pathologist #1 and 91.7% (kappa = 0.87) for pathologist #2. Diagnostic performance concordance between FuCM and Hamp;E to discern adenomatous from nonadenomatous polyps was 100% (kappa = 1) for pathologist #1 and 97.2% (kappa = 0.94) for pathologist #2. Global interobserver agreement was 94.44% (kappa = 0.91) and kappa = 0.94 to distinguish adenomatous from nonadenomatous polyps. Conclusions: Ex vivo FuCM shows an excellent correlation with standard Hamp;E for the diagnosis of colorectal polyps. The clinical direct benefit for patients, pathologists, and endoscopists allows adapting personalized surveillance protocols after colonoscopy and a workload decrease in pathology departments.
Pathobiology

中文翻译：

---

结直肠息肉的离体融合共聚焦显微镜：病理诊断的快速周转时间

背景：结直肠癌筛查项目已经降低了该疾病的死亡率，但在内窥镜检查单位和病理学部门造成了瓶颈。我们旨在探索体外融合共聚焦显微镜 (FuCM) 提高组织病理学诊断效率和减少实验室工作量的可行性。方法：使用离体FuCM对结肠镜下连续切除的新鲜息肉进行扫描，然后进行组织病理学检查和苏木精和伊红（Hamp;E）诊断。两名对 Hamp;E 诊断不知情的病理学家根据 FuCM 扫描图像进行了诊断。结果：来自 22 名患者的 36 个新鲜息肉被诊断为 FuCM 和 Hamp;E。Hamp;E 和 FuCM 之间的诊断一致性对于病理学家 #1 为 97.2% (kappa = 0.96)，对于病理学家 #2 为 91.7% (kappa = 0.87)。FuCM 和 Hamp;E 在区分腺瘤性息肉和非腺瘤性息肉方面的诊断性能一致性为 1 号病理学家的 100% (kappa = 1) 和 2 号病理学家的 97.2% (kappa = 0.94)。全球观察者间一致性为 94.44% (kappa = 0.91) 和 kappa = 0.94，以区分腺瘤性息肉和非腺瘤性息肉。结论：离体 FuCM 显示出与标准 Hamp;E 对结直肠息肉诊断的极好相关性。对患者、病理学家和内镜医师的临床直接益处允许在结肠镜检查后调整个性化监测方案并减少病理学部门的工作量。
病理学