Conflict of interest: None.
Confocal laser endomicroscopy for the diagnosis of colorectal cancer in vivo
Article first published online: 15 APR 2013
© 2013 The Authors. Journal of Digestive Diseases © 2013 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd
Journal of Digestive Diseases
Volume 14, Issue 5, pages 259–265, May 2013
How to Cite
Liu, C., Li, C. Q., Zuo, X. L., Ji, R., Xie, X. J., Yang, Y. S. and Li, Y. Q. (2013), Confocal laser endomicroscopy for the diagnosis of colorectal cancer in vivo. Journal of Digestive Diseases, 14: 259–265. doi: 10.1111/1751-2980.12039
- Issue published online: 15 APR 2013
- Article first published online: 15 APR 2013
- Accepted manuscript online: 21 JAN 2013 08:46AM EST
- Key National Clinical Project of the Ministry of Health of China
- Youth Fund from the National Natural Science Foundation of China. Grant Number: 81101098
- colorectal cancer;
- confocal laser endomicroscopy;
To evaluate the feasibility and accuracy of confocal laser endomicroscopy (CLE) for the in vivo diagnosis of colorectal cancer (CRC) compared with conventional histology.
Consecutive patients who had undergone CLE examination for screening or surveillance colonoscopy were recruited. Suspected malignant lesions and adjacent mucosal sites were first examined by confocal imaging and then biopsied specimens of these sites were obtained. The confocal images were independently interpreted by two endoscopists. The diagnosis made with CLE was compared with the conventional histological diagnosis in a prospective and blinded fashion.
In total, 71 patients with suspected malignant lesions were included in the study. A total of 74 lesions and 92 adjacent mucosal sites were observed. The sensitivity, specificity and accuracy of CLE in diagnosing CRC were 97.1%, 99.0% and 98.2% for endoscopist A, and 98.6%, 96.9% and 97.6% for endoscopist B, respectively. The interobserver agreement between the two endoscopists was excellent (κ = 0.950). The accuracy of diagnosing poorly differentiated CRC using CLE was 97.0% for endoscopist A and 95.6% for endoscopist B.
CLE has the potential to enable an immediate diagnosis of CRC and the degree of differentiation of CRC during ongoing endoscopy in vivo.