The CLE diagnosis of the mucin phenotype in gastric cancers was limited to intestinal and mixed phenotypes but may be useful for the diagnosis of mucin phenotype and differential diagnosis.
CLE is an acceptable and potentially useful technology for the identification and grading of gastric intraepithelial neoplasia in vivo. The diagnostic accuracy needs to be improved.
CLE demonstrates a high diagnostic accuracy for gastric epithelial neoplasia. The use of CLE could possibly reduce the number of unnecessary biopsies and mistaken diagnoses before endoscopic submucosal dissection.
CEL has high accuracy for prediction of remnant tissue after endoscopic mucosal resection and may lead to significant improvements in clinical surveillance after endoscopic resection.
pCLE can provide an accurate diagnosis for superficial gastric neoplasia, and it has the potential to compensate for the inherent limitations of a conventional endoscopic biopsy.
CLE is useful for identifying gastric metaplasia. These findings could have potential applicability for duodenal screening and suggest a possible targeting therapy in functional dyspepsia.
CLE allows functional imaging of mucosal barrier defects. Gastric intestinal metaplasia is associated with an impaired paracellular barrier irrespective of H. pylori eradication.
pCLE was superior to autofluorescence imaging and white-light endoscopy for diagnosing gastric intestinal metaplasia. Off-site review improved performance of pCLE.
Combining pCLE with magnifying flexible spectral imaging color enhancement (ME-FICE) provides high sensitivity and NPV for gastric intestinal metaplasia detection. The prompt histology reading by this technique may avoid unnecessary biopsy.
CLE with targeted biopsies is superior to white-light endoscopy with standard biopsies for the detection and surveillance of gastric intestinal metaplasia. The number of biopsies needed to confirm gastric intestinal metaplasia is about one-third of that needed with white-light endoscopy with standard biopsies.
CLE can detect epithelial damage and barrier loss in the duodenum of Crohn’s Disease and Ulcerative Colitis patients that is not apparent on conventional endoscopy or histology.
The assessment of duodenal histology by CLE in patients with celiac disease is sensitive and specific in determining increased numbers of intraepithelial lymphocytes and villous atrophy but insufficient in respect of crypt hyperplasia. For routine use of CLE in patients with celiac disease, the technique would need to be improved.
CEL offers the prospect of diagnosis of celiac disease during ongoing endoscopy. It also enables targeting biopsies to abnormal mucosa and thereby increasing the diagnostic yield, especially when villous atrophy is patchy in the duodenum.
stands for the number of patients enrolled in the study; n/a, not available or not applicable; pCLE, probe-based confocal laser endomicroscopy; CLE, confocal laser endomicroscopy; PPV, positive predictive value; NPV, negative predictive value; and BE, Barrett’s esophagus.
