DIAGNOSIS OF GASTRIC AND DUODENAL EPITHELIAL TUMORS BY CONFOCAL LASER ENDOMICROSCOPY

Abstract

Endoscopic techniques have markedly progressed with recent technological innovations, and the era of “optical biopsy” capable of real-time observation of tissue at 1,000-times magnification has begun. The author has studied the diagnosis of digestive tract diseases by confocal laser endomicroscopy since 2014. Firstly, the author succeeded in acquiring images equivalent to those employing intravenous fluorescein administration, which has been considered essential for confocal laser endomicroscopy, by dripping a very small volume of fluorescein, and reported it as the “fluorescein dripping method”.

In the stomach, confocal laser endomicroscopy findings are diverse and diagnostics have not yet been established, but the presence of different histologic types of gastric cancer is considered and a classification system to differentiate them may be established as a method substituting for biopsy. The author proposed the “ABC-C classification” as very useful for differentiation of duodenal epithelial tumors, which is difficult using the current conventional and magnifying observations. Studies on “molecular imaging” using confocal laser endomicroscopy are being actively performed in Western countries, and their results seem to be promising.