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- W2052130806 abstract "Introduction: A newly developed technique, denoted confocal laser endomicroscopy, allows subsurface analysis of the intestinal mucosa and in vivo histology during ongoing endoscopy. Here, we have applied this technique to the in vivo diagnosis of Barrett's epithelium and associated neoplasias in patients with gastroesophageal reflux disease (GERD). Methods: A prospective study on confocal laser endoscopy was conducted in patients with the indications long lasting reflux symptoms or surveillance endoscopy (known Barrett's esophagus) as well as patients with suspected Barrett's associated neoplasias. Fluorescein aided endomicroscopy was performed by applying the endomicroscope over the whole columnar lined lower esophagus (CLE). Images obtained within 1 cm of CLE were digitally stored and targeted biopsies or endoscopic mucosal resection of the examined areas were performed. In vivo histology was compared with the histological specimens. All digitally stored images were re-assessed by a blinded investigator using the newly developed Confocal Barrett Classification to predict histology. Intra- and interobserver variations of the involved endoscopists were evaluated by using kappa statistics. Results: 42 patients fulfilled all inclusion criteria and were enrolled in this study. Endomicroscopy allowed to distinguish between different types of epithelial cells and detected cellular and vascular changes in Barrett's epithelium at high resolution during ongoing endoscopy. Barrett's esophagus and associated neoplasias could be predicted with a sensitivity of 98.8%/91.7% and a specificity of 94.4%/99.0%, respectively (Accuracy: each 97.5%). The mean kappa for interobserver agreement for the prediction of histopathologic diagnosis was 0.843, whereas intraobserver agreement showed a mean kappa of 0.892. Discussion: Fluorescence aided endomicroscopy is a new diagnostic tool for Barrett's esophagus that allows in vivo histology of the mucosal layer during ongoing endoscopy. Gastric and Barrett's epithelium as well as Barrett's associated neoplastic changes can be diagnosed with high accuracy. Thus, endomicroscopy may be helpful for surveillance of patients with GERD." @default.
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- W2052130806 date "2005-04-01" @default.
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- W2052130806 title "In Vivo Histology of Barrett's Esophagus and Associated Neoplasias By Confocal Laser Endomicroscopy" @default.
- W2052130806 doi "https://doi.org/10.1016/s0016-5107(05)00659-0" @default.
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