Dept of Medicine 1, University of Erlangen–Nuremberg, Erlangen, Germany.
Eur Respir J. 2013 Jun;41(6):1401-8. doi: 10.1183/09031936.00062512. Epub 2012 Sep 20.
Confocal laser endomicroscopy is a novel endoscopic technique that may allow imaging of living cells in lung tissue in vivo. We assessed the potential of this technique for the detection of histology during screening bronchoscopy for lung cancer. 32 patients with suspected malignancies underwent bronchoscopy with endomicroscopy using acriflavine hydrochloride. Standardised areas and localised lesions were analysed by in vivo confocal imaging during bronchoscopy and biopsies were taken. Confocal images were graded and correlated prospectively with conventional histology from biopsies. Acriflavine hydrochloride yielded high-quality confocal images and strongly labelled airway epithelial cells. No side-effects were noted. 75,522 confocal images from 56 different locations were compared prospectively with histological data from biopsy specimens. Endomicroscopy allowed subsurface imaging with detailed analysis of cellular and subcellular structures. Neoplastic changes could be predicted with high accuracy (sensitivity 96.0%, specificity 87.1%, accuracy 91.0%). Confocal laser endomicroscopy with acriflavine is a novel diagnostic tool for the analysis of living cells during bronchoscopy and permits virtual histology of neoplastic changes in the airways with high accuracy. This technique may enable the rapid diagnosis of neoplasia during ongoing endoscopy in patients with suspected lung cancer.
共聚焦激光内镜检查是一种新型的内镜技术，可在活体内对肺组织中的活细胞进行成像。我们评估了该技术在肺癌筛查支气管镜检查中检测组织学的潜力。32 名疑似恶性肿瘤的患者接受了盐酸吖啶橙内镜检查。在支气管镜检查过程中通过体内共聚焦成像分析标准化区域和局部病变，并进行活检。对共聚焦图像进行分级，并与活检的常规组织学进行前瞻性相关性分析。盐酸吖啶橙产生高质量的共聚焦图像，并强烈标记气道上皮细胞。未观察到副作用。从 56 个不同部位获得的 75522 个共聚焦图像与活检标本的组织学数据进行前瞻性比较。内镜检查允许进行亚表面成像，对细胞和亚细胞结构进行详细分析。肿瘤变化可以高精度预测（敏感性 96.0%，特异性 87.1%，准确性 91.0%）。用吖啶橙进行共聚焦激光内镜检查是一种用于在支气管镜检查期间分析活细胞的新型诊断工具，可高度准确地对气道中的肿瘤变化进行虚拟组织学检查。该技术可能使在怀疑患有肺癌的患者进行的持续内镜检查中能够快速诊断肿瘤。
