title: Optical biopsy of early gastroesophageal cancer by catheter-based reflectance-type laser-scanning confocal microscopy.
abstract: Magnified endoscopic observation of the gastrointestinal tract has become possible. However, such observation at the cellular level remains difficult. Laser-scanning confocal microscopy (LCM) is a novel, noninvasive optical imaging method that provides instant microscopic images of untreated tissue under endoscopy. We compare prototype catheter-based reflectance-type LCM images in vivo and histologic images of early gastroesophageal cancer to assess the usefulness of LCM in diagnosing such cancer. 20 sites in the esophagus and 40 sites in the stomach are examined by LCM under endoscopy prior to endoscopic or surgical resection. A prototype catheter LCM system, equipped with a semiconductor laser that oscillates at 685 nm and analyzes reflected light (Mauna Kea Technologies, Paris, France; Fujinon, Saitama, Japan) is used in vivo without fluorescent agent. In all normal esophageal mucosa and esophageal cancers, the nuclei are visualized. In nine of the ten normal esophageal mucosa, cell membranes are visualized, and in five of the ten esophageal cancers, cell membranes are visualized. In all normal gastric mucosa, nuclei and cell membranes are not visualized, but in ten of the 20 gastric cancers, nuclei are visualized. This novel method will aid in immediate diagnosis under endoscopy without the need for biopsy.
authors.affiliation: Hiroshima University, Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima, Japan.
authors.forename: Madoka
authors.initials: M
authors.lastname: Nakao
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yoshida
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Takemura
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshihara
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D001706:Biopsy / Q000295:instrumentation*; D002404:Catheterization; D017076:Computer-Aided Design; D004867:Equipment Design; D019544:Equipment Failure Analysis; D004938:Esophageal Neoplasms / Q000473:pathology*; D006801:Humans; D018613:Microscopy, Confocal / Q000295:instrumentation*; D055096:Optical Devices; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000473:pathology*