Confocal Laser Endomicroscopy for Detection of Early Upper Gastrointestinal Cancer

Wei Han, Rui Kong, Nan Wang, Wen Bao, Xinli Mao, Jie Lu, Wei Han, Rui Kong, Nan Wang, Wen Bao, Xinli Mao, Jie Lu

Abstract

Esophageal and gastric cancers are common diseases with high morbidity and mortality; thus, early detection and treatment are beneficial to improve prognosis. Confocal laser endomicroscopy (CLE) is a novel imaging technique that permits the histological analysis of tissues during endoscopy. CLE has been shown to uniquely affect the diagnosis of early upper gastrointestinal cancers. Relevant literature was searched using PubMed and Google Scholar databases. Despite inherent flaws, CLE can reduce tissue damage and improve diagnostic accuracy to a certain extent. CLE in combination with other imaging methods can help enhance the detection rate and avoid unnecessary biopsies in the management of esophageal or gastric cancer and precancerous lesions. CLE is of great significance in the diagnosis and surveillance of early cancers of the upper gastrointestinal tract. Further technical innovations and the standardisation of CLE will make it more responsive to the needs of routine clinical applications.

Keywords: Barrett’s esophagus; CLE; early gastric cancer; early oesophageal cancer.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Examples of CLE images in the human esophagus. CLE showed high-grade dysplasia with irregularly thickened epithelial borders and dilated irregular vessels (a,b). CLE showed inhomogeneous squamous epithelium with irregular architecture and unclear cell boundaries in the early esophageal squamous cell neoplasm (c,d).
Figure 2
Figure 2
Examples of CLE images in the human stomach. CLE showed glandular atrophy with decreased gastric pits and markedly dilated opening (a). CLE showed gastric intestinal metaplasia with dark goblet cells within the columnar epithelium (b). CLE showed high-grade intraepithelial neoplasia with distorted pits and irregular epithelial lining in cardia of the stomach (c,d). CLE showed moderately differentiated adenocarcinoma with atypical/naive glands and dark epithelium (e,f).

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