Zhang Jian-na, Yu Tao, Li Yan-qing, Guo Yu-ting, Liu Hong, Zhang Jian-ping
Department of Gastroenterology, Qilu Hospital, Shandong University, Jinan 250012, China.
Zhonghua Nei Ke Za Zhi. 2007 Oct;46(10):835-7.
Confocal endomicroscope (CEM) is a newly developed endoscope based on the integration of a confocal laser scanning microscope at the distal tip of a conventional video endoscope. It can visualize living tissue at a cellular level. The aim of the present study was to assess the value of CEM for prediction of the histopathology of gastric depressed-type lesions during endoscopy.
Forty-three patients with gastric depressed-type lesions underwent CEM and 51 depressed-type lesions were examined. Confocal diagnosis was made according to cellular and gastric pit morphology and compared with conventional histopathologic findings of corresponding biopsy specimens from the observed sites in a prospective and double-blinded fashion.
The marginal and/or middle areas of every depressed-type lesion were examined by confocal imaging and a total of 4872 confocal images were obtained from 172 locations. Fluorescein sodium aided CEM to yield clear fluorescent images in vivo which allowed detailed analysis of surface and subsurface cellular and gastric pit architecture. A total of 46 biopsy specimens from 19 patients were diagnosed as gastric cancer. Confocal images had a sensitivity of 95.7%, a specificity of 97.6%, and accuracy of 97.1% for gastric cancer.
CEM can provide virtual histopathology of gastric cancer with high accuracy during endoscopy and it is of potential value for the differential diagnosis of gastric depressed-type lesions and early detection of gastric cancer.
共聚焦内镜显微镜（CEM）是一种新开发的内镜，它是将共聚焦激光扫描显微镜集成在传统视频内镜的尖端。它能够在细胞水平可视化活体组织。本研究的目的是评估CEM在内镜检查期间预测胃凹陷型病变组织病理学的价值。
43例患有胃凹陷型病变的患者接受了CEM检查，共检查了51个凹陷型病变。根据细胞和胃小凹形态进行共聚焦诊断，并以前瞻性双盲方式与来自观察部位的相应活检标本的传统组织病理学结果进行比较。
通过共聚焦成像检查了每个凹陷型病变的边缘和/或中间区域，从172个位置共获得4872张共聚焦图像。荧光素钠辅助CEM在体内产生清晰的荧光图像，从而能够详细分析表面和亚表面的细胞及胃小凹结构。19例患者的46份活检标本被诊断为胃癌。共聚焦图像对胃癌的敏感性为95.7%，特异性为97.6%，准确性为97.1%。
CEM能够在内镜检查期间高精度地提供胃癌的虚拟组织病理学，对胃凹陷型病变的鉴别诊断和胃癌的早期检测具有潜在价值。
