Confocal Laser Endomicroscopy in the Diagnostics of Malignancy of the Gastrointestinal Tract


Klin Onkol 2017; 30(4): 258-263. DOI: 10.14735/amko2017258.

In confocal laser endomicroscopy (CLE), a type of optical microscope that uses a laser beam as its light source and processes the acquired image by processor unit is used. Although the principle behind the device has been known since 1957, its use in clinical practice has only recently been enabled by technical developments, and it is therefore a relatively new modality in differential diagnosis. CLE enables real-time microscopic imaging of the tissue under investigation and in fact non-invasive in vivo biopsy. First experiences with CLE have primarily been obtained in the field of endoscopy, in particular in the pathology of the esophagus, stomach, bile duct, pancreas, and colon. Further to its use in endoscopy, CLE was recently developed for perioperative use, with the most experience gained in neurological, breast, and prostate surgery. Numerous prospective randomized trials have confirmed the benefits of CLE in tumor screening, differential diagnosis of tumors or inflammatory diseases, earlier diagnostics of diseases, and reducing the number of required endoscopic examinations. In addition, CLE is associated with minimal side effects. A known possible side effect is allergy to the fluorescein used to stain tissues during the examination. Extending of endoscopic examination or surgery is minimal in the hands of trained personnel. Current limiting factors of CLE include insufficient clinical experience, the price of the CLE device and probes, and the subjectivity inherent in the evaluation of microscopic images by the endoscopist or surgeon. This article summarizes published studies of CLE in the diagnostics of oncological diseases of the gastrointestinal tract.

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