Identification Of The Tumor Boundary Of Hilar Cholangiocarcinoma Based On Multiphoton Microscopy

Hilar cholangiocarcinoma is the disease with the highest incidence of extrahepatic cholangiocarcinoma.Its early symptoms are hidden and the prognosis is poor.As the number of people suffering from cancer is increasing year by year,the methods of treating hilar cholangiocarcinoma are diversified.Among them,surgical removal of the tumor is one of the most important methods of curing,which can prolong survival.In tumor resection,doctors often pay special attention to the marginal part of the tumor,because whether the tumor is completely removed is not only a key factor affecting the patient's postoperative recovery,but also a necessary condition for the cure of hilar cholangiocarcinoma.Complete tumor resection refers to achieving radical R0 resection,that is,no residual cancer cells under the microscope.Multiphoton microscopy(MPM)based on two-photon excitation fluorescence(TPEF)and second harmonic generation(SHG)not only has ultra-high spatial resolution and large imaging depth at the cellular and even subcellular level,but also can achieve non-destructive,label-free imaging of biological tissues.This paper first differentiate normal bile duct tissue,chronic cholangitis and cholangiocarcinoma from a qualitative perspective.The experimental results show that the tissue morphology of the three groups is quite different and can be distinguished.Then,this paper distinguish between normal bile duct tissue and cholangiocarcinoma tissue from a quantitative perspective,namely,the density of collagen fibers and the width of collagen fibers.The experimental results show that there are significant differences in density and width of collagen fiber between normal bile duct tissue and cholangiocarcinoma tissue,which can be distinguished more accurately through quantitative analysis.Finally,for hilar cholangiocarcinoma with a higher incidence,the cancerous tissue needs to be completely removed to achieve negative incisal margins.For the incisal margin,this paper not only identify it from the aspect of tissue morphology,but also calculate the density of collagen fiber and the two-dimensional orientation angle of the collagen fiber.Although the two of them can be used to identify the incisal margins,in order to improve the accuracy,this paper use logistic regression to combine them to form a prediction curve.The prediction curve can well distinguish the surgical margin.In summary,MPM can not only distinguish normal and cancerous bile duct tissues,but also can further judge the surgical margin to ensure that the incisal margin is negative.With the continuous optimization and development of MPM,the research methods and experimental data of this paper can provide certain guidance for the identification of normal bile duct and cholangiocarcinoma and the judgment of the surgical margin of hilar cholangiocarcinoma.