Innere Medizin I, Universitätsklinikum Tübingen, Otfried-Müller-Straße 10, 72076 Tübingen, Germany.
St. Marienkrankenhaus, Richard-Wagner-Straße 14, 60318 Frankfurt, Germany.
Nat Rev Gastroenterol Hepatol. 2014 Jan;11(1):11-8. doi: 10.1038/nrgastro.2013.134. Epub 2013 Jul 30.
Performing real-time microscopy has been a vision of endoscopists since the very early phases of gastrointestinal endoscopy. Confocal endomicroscopy, an adaption of confocal laser scanning microscopy, and endocytoscopy, an adaption of white-light microscopy, have been introduced into the endoscopic armamentarium in the past decade. Both techniques yield on-site histological information. Multiple trials have demonstrated the ability of gastroenterologists to obtain and interpret microscopic images from the upper and lower gastrointestinal tract, and also the hepatobiliary-pancreatic system, during endoscopy. Such microscopic information has been successfully used in expert hands to minimize sampling error by 'smart', microscopically targeted biopsies and to guide endoscopic interventions. However, endomicroscopy is also unique in its ability to dynamically visualize cellular processes in their native environment free of artefacts. This ability enables fundamental insights into mechanisms of human diseases in clinical and translational science.
实时显微镜检查一直是内窥镜医师的愿景，早在胃肠内窥镜检查的早期阶段就已经如此。过去十年中，共聚焦内镜检查（一种共聚焦激光扫描显微镜的适应技术）和内镜细胞检查（一种白光显微镜的适应技术）已被引入内镜检查中。这两种技术都能提供现场组织学信息。多项试验已经证明，胃肠病学家能够在进行内窥镜检查时，从上消化道和下消化道以及肝胆胰腺系统中获取和解释微观图像。这种微观信息已被专家成功用于通过“智能”的、显微镜靶向活检来最小化采样误差，并指导内镜干预。然而，内镜检查也具有独特的能力，可以在无伪影的情况下动态观察原生环境中的细胞过程。这种能力使人们能够深入了解临床和转化科学中人类疾病的机制。
