Confocal Laser Endomicroscopy for Detection of Early Upper Gastrointestinal Cancer

Sep 24, 2026

Uploaded by hdkawk

Esophageal and gastric cancers are common, with high morbidity and mortality, making early detection and treatment essential for improving prognosis. Confocal laser endomicroscopy (CLE) is a novel endoscopic imaging approach that enables histological-level tissue analysis during endoscopy. Evidence synthesized from PubMed and Google Scholar indicates that CLE can enhance diagnostic performance for early upper gastrointestinal cancers, while potentially reducing tissue damage and unnecessary biopsies. Technical refinement and standardized use may further support routine clinical application.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages17

Reading Time43 min

AccessFree to download

Introduction

Principles and imaging capability of CLE

CLE system types for gastrointestinal endoscopy

cancers Review Confocal Laser Endomicroscopy for Detection of Early Upper Gastrointestinal Cancer Wei Han 1, Rui Kong 1, Nan Wang 1, Wen Bao 1, Xinli Mao 2,* and Jie Lu 3, * Citation: Han, W.; Kong, R.; Wang, N.; Bao, W.; Mao, X.; Lu, J. Confocal Laser Endomicroscopy for Detection of Early Upper Gastrointestinal Cancer. Cancers 2023, 15, 776 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers15030776 Academic Editor: Cosimo Sperti Received: 13 November 2022 Revised: 19 January 2023 Accepted: 23 January 2023 Published: 26 January 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Gastroenterology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China 2 Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Afﬁliated to Wenzhou Medical University, Zhejiang 317099, China 3 Department of Gastroenterology, Gongli Hospital of Shanghai Pudong New Area, Shanghai 200135, China * [Correspondence: maoxl@enzemed.com](Correspondence: maoxl@enzemed.com) (X.M.); [lj01682@glhospital.com](lj01682@glhospital.com) (J.L.) Simple Summary: Early diagnosis of digestive tract neoplasms is beneﬁcial for maximising the possibility of cure. The diagnostic efﬁcacy of conventional endoscopy is currently limited. Confocal laser endomicroscopy (CLE) can magnify tissue to the cellular level, which is beneﬁcial for endoscopic biopsy. Currently, its clinical application has attracted wide interest among endoscopists. Many studies have explored its application potential in the early diagnosis of digestive tract tumours. This paper reviewed a large number of clinical studies on CLE in early esophageal and gastric cancers, providing more evidence-based support for endoscopists in making clinical decisions. Abstract: Esophageal and gastric cancers are common diseases with high morbidity and mortality; thus, early detection and treatment are beneﬁcial to improve prognosis. Confocal laser endomicroscopy (CLE) is a novel imaging technique that permits the histological analysis of tissues during endoscopy. CLE has been shown to uniquely affect the diagnosis of early upper gastrointestinal cancers. Relevant literature was searched using PubMed and Google Scholar databases. Despite inherent ﬂaws, CLE can reduce tissue damage and improve diagnostic accuracy to a certain extent. CLE in combination with other imaging methods can help enhance the detection rate and avoid unnecessary biopsies in the management of esophageal or gastric cancer and precancerous lesions. CLE is of great signiﬁcance in the diagnosis and surveillance of early cancers of the upper gastrointestinal tract. Further technical innovations and the standardisation of CLE will make it more responsive to the needs of routine clinical applications. Keywords: CLE; early oesophageal cancer; early gastric cancer; Barrett's esophagus 1. Introduction Owing to high morbidity and mortality levels, upper gastrointestinal cancers have become severe malignant diseases that threaten people's health worldwide. In the latest global cancer statistics report in 2020, the incidence of esophageal cancer was 3.1%(seventh place), the mortality rate was 5.5%(sixth place), the incidence of gastric cancer was 5.6%, ranking ﬁfth, while the mortality rate was 7.7%, the fourth highest among all cancers [1] . The early diagnosis of upper gastrointestinal cancers and precancerous lesions is of great value for their treatment and prognosis. Traditional white light endoscopy (WLE) has many limitations in the observation of microscopic lesions. The evolving optical-based endoscopy tec

FAQs

What is confocal laser endomicroscopy (CLE) and how does it work during endoscopy?

CLE is an imaging technique that illuminates the mucosal surface with a blue laser and detects fluorescence reflected from tissue. It refocuses light from a specific depth to enhance image resolution during endoscopy.

Why is CLE important for early upper gastrointestinal cancers?

Early detection improves treatment outcomes, and conventional white light endoscopy has limitations for microscopic lesions. CLE can magnify mucosal structures to the cellular or subcellular level, supporting more accurate diagnosis and biopsy guidance.

What kinds of CLE systems are used for gastrointestinal endoscopy?

The document describes eCLE (integrated mini confocal scanner in a specialized flexible endoscope), pCLE (a flexible confocal microprobe through endoscope channels), and needle-based CLE (nCLE) using a miniprobe delivered via an EUS-FNA needle for optical needle biopsy.

Sep 24, 2026

Uploaded by hdkawk