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DOI: 10.1055/s-2007-981404
© Georg Thieme Verlag Stuttgart · New York
Die Rolle der konfokalen Laserfluoreszenz-Mikroskopie in der Detektion früher Neoplasien des Gastrointestinaltrakt
Confocal Laser-Fluorescence Microscopy for Detection of Early Neoplasia in the Gastrointestinal TractPublication History
Publication Date:
21 December 2007 (online)
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Zusammenfasung
Durch die konfokale Lasermikroskopie besteht die Möglichkeit, in vivo während einer laufenden endoskopischen Untersuchung eine mit der Standardhistologie vergleichbare Beurteilung der Schleimhaut zu erreichen. Dies könnte in Zukunft die Zahl der Biopsien reduzieren und somit Zeit und Kosten einsparen. Bisherige monozentrische Studien zum Einsatz der konfokalen Lasermikroskopie bei Patienten mit Barrett-Ösophagus, Colitis ulcerosa oder zur Detektion von Adenomen des Kolons zeigen eine hohe diagnostische Treffsicherheit. Prospektive Multizenterstudien zu diesen Themen sind bereits in der Umsetzung, je nach Ausgang dieser Studien wird sich beurteilen lassen können inwieweit diese neue Methode das Potenzial hat in der täglichen Praxis eingesetzt zu werden. Als weitere zukünftige Einsatzgebiete denkbar ist die Abgrenzung von Stenosen des hepatobiliären Systems oder das Monitoring einer laufenden Therapie etwa mit Angiogenesehemmern.
Abstract
Confocal laser microscopy enables in vivo histopathology during ongoing endoscopy. This new technique has therefore the potential to reduce the numbers of biopsies. Thereby, time may be shortened spent until a final diagnosis is established. In addition, histopathology associated costs can be reduced. Single center studies have shown that confocal lasermicroscopy is highly accurate if applied in patients with Barrett's esophagus, ulcerative colitis or colonic adenomas. Prospective multi-center studies for further investigation of this new modality are ongoing. The results obtained by these studies will show whether this technique has the potential to be integrated in a daily routine manner. Further fields of research cover the evaluation of hepato-biliary strictures or monitoring of ongoing anti-angiogenetic therapy.
Schlüsselwörter
Endoskopie - Histologie - Endomikroskopie - Karzinom - gastrointestinal - Laserscanning-Mikroskopie - konfokale Miniproben
Key words
endoscopy - histology - endomicroscopy - cancer - gastrointestinal - laser scanning microscopy - confocal miniprobes
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PD Dr. med. A. Meining
II. Medizinische Klinik · Technische Universität München · Klinikum Rechts der Isar
Ismaningerstr. 22
81675 München
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Phone: +49 / 89 / 4 14 00
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Email: alexander.meining@lrz.tum.de