Rapid Pathological Detection Of Breast Cancer Margins In Breast-conserving Surgery Based On Polarization Imaging Technology

Objective:Through comparing the results of 120 cases of breast cancer unstained pathological section detected by the polarized light imaging system with the results of paraffin pathological diagnosis,calculating the sensitivity and specificity of the detection,and recording the time for the computer to extract the sample information in each detection,we aim to evaluate the feasibility of polarized light imaging as a method for rapid pathological detection during breast-conserving surgery for breast cancer.Methods:86 puncture tissues of invasive ductal carcinoma of the breast and 34 puncture tissues of ductal carcinoma in situ were collected from the postoperative unstained paraffin pathological section,where every section contained both normal tissue and cancerous tissue.All specimens were collected from breast cancer patients in breast surgery department of the First Hospital of Jilin University from July 2018 to December 2020,and all of them were pathologically confirmed.Before surgery,all patients signed the informed consent for their breast cancer-related tissue samples to be used in scientific research.For each specimen,the pathologist confirmed the boundary between normal tissue and cancerous tissue under a light microscope,and then placed it into a complete polarized light imaging system.After the CCD camera completed the acquisition of the image,the image is transmitted to the computer.The MATLAB software with set parameters completed the transformation and decomposition of the Mueller matrix,and then the pseudo-color image of the phase delay parameter of the detected tissue can be obtained,where the difference in phase delay between different tissues was visible.Combined with the demarcation of normal tissue and the cancerous tissue confirmed under light microscope,we can count the correct number of120 cases of slices detected in the polarized light imaging system,calculated the sensitivity and specificity,and finally evaluated the consistency with the paraffin pathological diagnosis results.Meanwhile,we also calculated the time required by the computer to extract the tissue structure at each time.All data were analyzed by SPSS 26.0 software.We used either Chi-square test or Fisher’s exact test to compare the differences between groups,and we regarded the statistical results with P<0.05 as being statistically significant.Results:Whether it is normal tissue or cancerous tissue,there is no significant difference in the correct rate of polarized light imaging in the detection of 86 cases of invasive ductal carcinoma and 34 cases of ductal carcinoma in situ.There is also no significant correlation between the accuracy of this technique for the detection of these two different types of breast cancer tissue and the difference between the two pathological types（P>0.05）.The detection sensitivity of this technique was 91.67%,the specificity was 68.33%,the kappa value was 0.6,and the consistency with the detection results of paraffin pathological sections was moderate.Conclusions:（1）In this study,the polarized light imaging system had no significant difference in the correct rate of detection of invasive ductal carcinoma and ductal carcinoma in situ pathological tissue white films.（2）The sensitivity of the polarized light imaging system for the detection of white slices of breast cancer pathological tissue was 91.63%,and the specificity was 68.33%,which was moderately consistent with the results of paraffin pathological diagnosis.