Confocal endomicroscopy： Is it time to move on？

• 作者: Carlos Robles-Medranda
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: CONFOCAL LASER ENDOMICROSCOPY In-vivomicroscopy Barret ESOPHAGUS GASTROINTESTINAL cancer CONFOCAL LASER ENDOMICROSCOPY probe
• 年，卷（期）: 2016,（1）
• 页码范围: 1-3
• 页数: 3页
• 分类号: R

摘要

Confocal laser endomicroscopy permits in-vivo microscopyevaluation during endoscopy procedures. Itcan be used in all the parts of the gastrointestinaltract and includes Esophagus, stomach, small bowel,colon, biliary tract through and endoscopic retrogradecholangiopancreatography and pancreas through needlesduring endoscopic ultrasound procedures. Many researchesdemonstrated a high correlation of results betweenconfocal laser endomicroscopy and histopathology inthe diagnosis of gastrointestinal lesions; with accuracyin about 86% to 96%. Moreover, in spite that histopathologyremains the gold-standard technique for finaldiagnosis of any diseases; a considerable number ofmisdiagnosis rate could be present due to many factorssuch as interpretation mistakes, biopsy site inaccuracy,or number of biopsies. Theoretically; with the diagnosticaccuracy rates of confocal laser endomicroscopycould help in a daily practice to improve diagnosis andtreatment management of the patients. However, it isstill not routinely used in the clinical practice due to manyfactors such as cost of the procedure, lack of codificationand reimbursement in some countries, absence ofstandard of care indications, availability, physician imageinterpretationtraining, medico-legal problems, and therole of the pathologist. These limitations are relative,and solutions could be found based on new researchesfocused to solve these barriers.