title: Probe-based confocal laser endomicroscopy: a new method for quantitative analysis of pit structure in healthy and Crohn's disease patients.
abstract: BACKGROUND
  Probe-based confocal laser endomicroscopy enables microscopic examination of the digestive mucosa.
  
  
  OBJECTIVE
  (1) To identify and validate quantitative endomicroscopic criteria for evaluation of the colonic mucosa and (2) to compare these criteria between healthy and Crohn's disease patients in clinical remission.
  
  
  METHODS
  Six healthy controls and ten Crohn's disease patients in clinical remission were included in this prospective study. Methylene blue-stained biopsies of the right colon and corresponding endomicroscopic images were analyzed. Major axis, minor axis, and major axis/minor axis ratio of crypt lumens were quantified.
  
  
  RESULTS
  Quantitative assessment was performed on 21 ± 4 crypt lumens per patient. Major axis/minor axis ratio values measured with endomicroscopy or methylene blue-stained biopsies were linearly correlated (r=0.63, p=0.01). All macroscopically inflamed mucosa had values of major axis/minor axis ratio higher than the median of controls. Interestingly, 50% (3/6) of Crohn's disease patients with macroscopically normal mucosa had also a higher ratio than pooled controls. Histological analysis showed that 6/7 patients with major axis/minor axis ratio superior to 1.7 had microscopic inflammation.
  
  
  CONCLUSIONS
  Probe-based confocal laser endomicroscopy allows quantitative analysis of colonic pit structure. Endomicroscopic analysis of major axis/minor axis ratio allows the detection of microscopic residual inflammation with greater accuracy than standard endoscopy in Crohn's disease patients in clinical remission.
authors: Digestive Diseases Institute, Nantes University Hospital, F-44093, France.
authors: Nicolas
authors: N
authors: Musquer
authors: Sabrina
authors: S
authors: Coquenlorge
authors: Arnaud
authors: A
authors: Bourreille
authors: Philippe
authors: P
authors: Aubert
authors: Tamara
authors: T
authors: Matysiak-Budnik
authors: Stanislas Bruley
authors: SB
authors: des Varannes
authors: Gregory
authors: G
authors: Lauwers
authors: Michel
authors: M
authors: Neunlist
authors: Emmanuel
authors: E
authors: Coron
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D016022:Case-Control Studies; D003106:Colon / Q000473:pathology*; D003424:Crohn Disease / Q000473:pathology*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007249:Inflammation / Q000473:pathology; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D008875:Middle Aged; D011446:Prospective Studies; D055815:Young Adult