{
  "abstract": "Background and objectives\n\nPrevious investigations have explored two-photon microscopy (TPM) for differentiating normal and malignant lesions in the digestive tract. The aim of this study is to evaluate label-free TPM for rapid, ex vivo classification of fresh endoscopic human gastric tissues across the spectrum of neoplastic progression, identify quantitative imaging biomarkers, and establish a basis for near real-time diagnostics.Methods\n\nSixty fresh gastric samples (8 normal, 34 chronic inflammation/metaplasia, 10 atypical hyperplasia, 8 malignant lesions) from 32 patients undergoing routine endoscopic biopsy were imaged using TPM without fixation/staining, generating 60 mosaics and 122 3D images. Key morphological features were established and validated by two blinded pathologists. Normal, chronic inflammation/metaplasia lesions were classified into the low-risk group, while atypical hyperplasia and malignant lesions were assigned to the high-risk group. Second-harmonic generation (SHG) quantified collagen area percentage (Area%) and orientation dispersion (Dispersion) to differentiate low-risk group from high-risk group.Results\n\nTPM provided high-resolution visualization of cellular/stromal features essential for pathology, comparable to histology but significantly faster. Blinded review showed substantial inter-reader agreement (Cohen's κ = 0.793) and 80.3% diagnostic accuracy across five tissue types. Quantitative analysis revealed high-risk lesions had significantly greater collagen Dispersion (U = 684, P < 0.001, r = -0.498) and higher Area% (U = 376, P < 0.001, r = -0.644) than low-risk lesions.Conclusions\n\nTPM offers a robust, label-free, rapid method for ex vivo assessment of gastric biopsies, accurately differentiating lesions from normal to malignant lesions. Increased collagen Dispersion and Area% serve as objective biomarkers for distinguishing high-risk lesions. These findings support TPM's transformative potential for near real-time pathological evaluation, accelerating diagnostics, improving biopsy targeting, and enabling AI-assisted bedside/intraprocedural tools in gastric atypical hyperplasia and malignant lesions management.",
  "abstract_shown": true,
  "affiliations": [
    "Southeast University School of Medicine, Nanjing, Jiangsu Province, China.",
    "Department of Gastroenterology, the First Medical Center of PLA General Hospital, Beijing, China.",
    "Nankai University School of Medicine, Nankai University, Tianjin, China.",
    "The College of Future Technology, Peking University, Beijing, China.",
    "Department of Pathology, the First Medical Center of PLA General Hospital, Beijing, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 14,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Bo Ning"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Xiaoqing Zhou"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Kaiyue Guan"
    },
    {
      "affs": [
        3
      ],
      "name": "Biao Yan"
    },
    {
      "affs": [
        1
      ],
      "name": "Qianqian Chen"
    },
    {
      "affs": [
        1
      ],
      "name": "Jinping Li"
    },
    {
      "affs": [
        1
      ],
      "name": "Shenzhen Liu"
    },
    {
      "affs": [
        1
      ],
      "name": "Qun Shao"
    },
    {
      "affs": [
        1
      ],
      "name": "Lihua Sun"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Sikun Zhang"
    },
    {
      "affs": [
        4
      ],
      "name": "Xinhua Ji"
    },
    {
      "affs": [
        3
      ],
      "name": "Dawei Li",
      "orcid": "0000-0003-0813-7821"
    },
    {
      "affs": [
        4
      ],
      "name": "Jinfeng Zang",
      "orcid": "0009-0001-8463-2915"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Enqiang Linghu",
      "orcid": "0009-0001-9549-5610"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/695aqpxbwzaby.bib",
  "cited_by": 0,
  "doi": "10.1515/jtim-2026-0070",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13726660/?tool=EBI",
  "id": "695aqpxbwzaby",
  "issns": [
    "2450-131X",
    "2224-4018"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13726660",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
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      "openalex",
      "1304|Advanced Fluorescence Microscopy Techniques"
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  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13726660/pdf/?tool=EBI",
  "pmcid": "PMC13726660",
  "pmid": "42974496",
  "published": "2026-08-24",
  "publisher": "De Gruyter",
  "ris": "https://research.draconitic.com/paper/695aqpxbwzaby.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:51Z",
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  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1304|Advanced Fluorescence Microscopy Techniques",
      "subfield": "biophysics"
    }
  ],
  "title": "Rapid, label-free differentiation of benign and malignant gastric lesions using two-photon microscopy and quantitative collagen analysis",
  "title_text": "Rapid, label-free differentiation of benign and malignant gastric lesions using two-photon microscopy and quantitative collagen analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T12:22:33Z",
  "url": "https://research.draconitic.com/paper/695aqpxbwzaby",
  "venue": "Journal of translational internal medicine",
  "versions": []
}