title: Clinical Correlation between Real-Time Endocytoscopy, Confocal Endomicroscopy, and Histopathology in the Central Airways.
abstract: BACKGROUND
  Lung cancer is one of the commonest malignancies with a worldwide incidence of 1.6 million cases each year. Although the main aetiological factor has been identified (cigarette smoking), the progression of lung cancer from early changes such as dysplasia through to cancer is still not fully understood. Furthermore, current research techniques are reliant on obtaining tissue biopsies, a process that alters the natural history of the very process under investigation. Hence, there is a need for developing optical biopsy techniques.
  
  
  OBJECTIVE
  To prospectively evaluate the feasibility of endocytoscopy and confocal endomicroscopy in the detection of malignant and pre-malignant changes in the airways.
  
  
  METHODS
  Findings with endocytoscopy and endomicroscopy were compared with conventional biopsies obtained from the same areas in 25 patients undergoing bronchoscopy for evaluation of endobronchial abnormalities and in 5 healthy control subjects.
  
  
  RESULTS
  Endocytoscopy was technically more difficult, and interpretable images were only obtained in 21 of the patients evaluated, and hence, complete information including histopathological information was available in 21 patients. Endocytoscopy appeared to correlate with the histopathological findings on tissue biopsy, and was able to distinguish normal epithelium from dysplasia and carcinoma. Confocal endomicroscopy was a more reliable technique with adequate visual information obtained in all patients examined but was unable to distinguish between dysplasia and carcinoma.
  
  
  CONCLUSIONS
  This feasibility study suggests that endocytoscopy may have the potential to fulfil the role of optical biopsy in the evaluation of the pathogenesis of lung cancer.
authors.affiliation: The National Institute for Health Research Respiratory Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, and Imperial College, London, UK.
authors.forename: Pallav L
authors.initials: PL
authors.lastname: Shah
authors.forename: Samuel V
authors.initials: SV
authors.lastname: Kemp
authors.forename: Richard C
authors.initials: RC
authors.lastname: Newton
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Elson
authors.forename: Andrew G
authors.initials: AG
authors.lastname: Nicholson
authors.forename: Guang-Zhong
authors.initials: GZ
authors.lastname: Yang
mesh_terms: D001980:Bronchi / Q000473:pathology*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D061848:Optical Imaging / Q000379:methods*; D011446:Prospective Studies