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Clinical impact of confocal laser endomicroscopy in the management of gastrointestinal lesions with an uncertain diagnosis

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World Journal of Gastrointestinal Endoscopy 2017年第8期9卷 389-395页

作者： Carlos Robles-Medranda Maria Vargas Jesenia Ospina Miguel Puga-Tejada Manuel Valero Miguel Soria Gladys Bravo Carlos Robles-Jara Hannah Pitanga Lukashok Gastroenterology and Endoscopy Division Instituto Ecuatoriano de Enfermedades DigestivasUniversity Hospital OMNIGuayaquil 090505Ecuador

To evaluate the clinical impact of confocal laser endomicroscopy (CLE) in the diagnosis and management of patients with an uncertain diagnosis. METHODSA retrospective chart review was performed. Patients who underwent CLE between November 2013 and October 2015 and exhibited a poor correlation between endoscopic and histological findings were included. Baseline characteristics, indications, previous diagnostic studies, findings at the time of CLE, clinical management and histological results were analyzed. Interventions based on CLE findings were also analyzed. We compared the diagnostic accuracy of CLE and target biopsies of surgical specimens. RESULTSA total of 144 patients were included. Of these, 51% (74/144) were female. The mean age was 51 years old. In all, 41/144 (28.4%) lesions were neoplastic (13 bile duct, 10 gastric, 8 esophageal, 6 colonic, 1 duodenal, 1 rectal, 1 ampulloma and 1 pancreatic). The sensitivity, specificity, positive predictive value, negative predictive value, and observed agreement when CLE was used to detect N-lesions were 85.37%, 87.38%, 72.92%, 93.75% and 86.81%, respectively. Cohen’s Kappa was 69.20%, thus indicating good agreement. Changes in management were observed in 54% of the cases. CONCLUSIONCLE is a new diagnostic tool that has a significant clinical impact on the diagnosis and treatment of patients with uncertain diagnosis.

关键词： Confocal laser endomicroscopy in vivo microscopy Barret esophagus Gastrointestinal cancer Pancreatic cyst Biliary strictures

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Confocal laser endomicroscopy as a new diagnostic tool for poorly differentiated gastric adenocarcinoma

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World Journal of Clinical Cases 2024年第26期12卷 5845-5849页

作者： Giuseppe Evola Marco Vacante Francesco R Evola Department of Surgery "Garibaldi"HospitalCatania 95100Italy Department of General Surgery and Medical-Surgical Specialties University of CataniaCatania 95123Italy Department of Surgery Division of Orthopedics and Trauma Surgery“Cannizzaro”HospitalCatania 95100Italy

Gastric cancer(GC)is a multifactorial disease,where both environmental and genetic features can have an impact on its occurrence and *** represents one of the leading causes of cancer-related deaths *** is most frequent in males and is believed to arise from a series of premalignant *** detection of GC at an early stage is crucial because early GC,which is an invasive stomach cancer confined to the mucosal or submucosal lining,may be curable with a reported 5-year survival rate of more than 90%.Advanced GC usually has a poor prognosis despite current treatment *** diagnostic efficacy of conventional endoscopy(with light endoscopy)is currently *** laser endomicroscopy is a novel imaging technique that allows real-time in vivo histological examination of mucosal surfaces during *** laser endomicroscopy may be of great importance in the surveillance of precancerous gastric lesions and in the diagnosis of *** this editorial we commented on the article about this topic published by Lou et al in the recent issue of the World Journal of Clinical Cases.

关键词： Confocal laser endomicroscopy in vivo microscopy Optical histology Helicobacter pylori Intestinal metaplasia Gastric atrophy Gastric cancer Early gastric cancer

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