Fluorescence microscopy of H&E stained cervical biopsies to assist the diagnosis and grading of CIN

Abstract

Background: Prevention of cervical cancer is based upon the accurate diagnosis and grading of cervical lesions identified during screening. The pathological classification of cervical intraepithelial neoplasia (CIN) is problematic, as it relies on subjective criteria and is known to have high interobserver variability and low reproducibility. These limitations can result in either over or under treatment of patients. Biomarkers to improve CIN diagnosis have not overcome all these challenges.

Main body: Here we review the use of a promising optical imaging method using eosin-based fluorescence spectroscopy. This technique is able to perform fluorescent analysis of cervical biopsies directly from hematoxylin and eosin (H&E) stained tissues. Eosin is a brominated derivative of fluorescein. Fluorescence characteristics of protein-eosin complexes can demonstrate tissue changes associated with dysplasia and cancer. In this article we review the progress made towards developing eosin-based fluorescence spectroscopy. We describe the various morphologies seen among the CIN grades with this optical method and highlight the progress made to quantitate the spectral image characteristics.

Conclusion: Eosin-based fluorescence spectroscopy can be used to directly examine H&E stained tissue slides. Relevant areas can be imaged and spectral analysis done to obtain objective data to identify and grade cervical lesions.

Keywords: Cervical neoplasia; Diagnostic imaging; Fluorescence imaging; Hematoxylin and eosin.