Needle-based confocal laser endomicroscopy for real-time diagnosing and staging of lung cancer.
Journal
The European respiratory journal
ISSN: 1399-3003
Titre abrégé: Eur Respir J
Pays: England
ID NLM: 8803460
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
10
08
2018
accepted:
18
03
2019
pubmed:
27
4
2019
medline:
30
10
2020
entrez:
27
4
2019
Statut:
epublish
Résumé
Diagnosing lung cancer in the absence of endobronchial abnormalities is challenging. Needle-based confocal laser endomicroscopy (nCLE) enables real-time microscopic imaging of cells. We assessed the feasibility and safety of using nCLE for real-time identification of lung cancer.In patients with suspected or proven lung cancer scheduled for endoscopic ultrasound (EUS), lung tumours and mediastinal lymph nodes were imaged with nCLE before fine-needle aspiration (FNA) was performed. nCLE lung cancer characteristics were identified by comparison with pathology. Multiple blinded raters validated CLE videos of lung tumours and mediastinal nodes twice.EUS-nCLE-FNA was performed in 22 patients with suspected or proven lung cancer in whom 27 lesions (six tumours, 21 mediastinal nodes) were evaluated without complications. Three nCLE lung cancer criteria (dark enlarged pleomorphic cells, dark clumps and directional streaming) were identified. The accuracy of nCLE imaging for detecting malignancy was 90% in tumours and 89% in metastatic lymph nodes. Both inter-observer agreement (mean κ=0.68, 95% CI 0.66-0.70) and intra-observer agreement (mean±sd κ=0.70±0.15) were substantial.Real-time lung cancer detection by endosonography-guided nCLE was feasible and safe. Lung cancer characteristics were accurately recognised.
Identifiants
pubmed: 31023849
pii: 13993003.01520-2018
doi: 10.1183/13993003.01520-2018
pii:
doi:
Types de publication
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Video-Audio Media
Langues
eng
Sous-ensembles de citation
IM
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright ©ERS 2019.
Déclaration de conflit d'intérêts
Conflict of interest: J. Yared has nothing to disclose. Conflict of interest: D.M. de Bruin has nothing to disclose. Conflict of interest: S.L. Meijer has nothing to disclose. Conflict of interest: P. Baas has nothing to disclose. Conflict of interest: P.I. Bonta has nothing to disclose. Conflict of interest: J.T. Annema reports non-financial material support from Mauna Kea Technologies during the conduct of the study. Conflict of interest: L. Wijmans has nothing to disclose.