Laguna SL, Salazar SAB, Magdaleno MGE, Chagoya Bello JC, Garrido SGA, Peña MES

Language: Spanish
References: 9
Page: 46-50
PDF size: 321.66 Kb.

ABSTRACT

Introduction: Confocal endomicroscopy (CFEM) is a new endoscopic modality, which allows very high resolution axial and lateral images to be obtained. This technique is probably the biggest revolution in diagnostic endoscopy today, as it allows the integration of macroscopic and microscopic vision in real time. It is obtained by means of an optical cut of cellular sample or of thick tissue using a very fine and parallel ultraviolet laser beam that touches a point of the tissue, causing a fluorescence that is captured by a selective filter, in this way, it is possible to obtain sections of the mucosa up to a depth of 250 mm with a greater resolution than with the optical microscope. Objectives: To assess the sensitivity and specificity of CFEM in the diagnosis of lung cancer for the taking of lung biopsy by bronchoscopy. Material and methods: A Cellvizio confocal endomicroscope (Mauna Kea Technology, Paris, France) and confocal mini probes were used. A prospective, cross-sectional, observational and diagnostic study was performed at the Respiratory Medicine Service of the Hospital Central Militar from August 2016 to August 2017. The sample was obtained at the convenience of lung cancer patients who were regularly taken to bronchoscopy for lung biopsy and that prior to the same CFEM was performed to determine the site of the same. Results: From the 60 patient study sample, thirteen patients were diagnosed with lung cancer, including eight patients diagnosed with adenocarcinoma, three with squamous cell carcinoma, and two with large cell carcinoma. The CFEM diagnosed 11 of the 13 cases of lung cancer, only two had to be taken to lung biopsy by surgical thoracoscopy; the rest of the patients had various diagnoses by pathology including organized pneumonia, alveolar hemorrhage, inflammatory processes and anthracosis. For CFEM a sensitivity of 0.76, specificity of 1 and a Cohen kappa index of 1 were obtained. Conclusions: For the CFEM as a diagnostic test of lung cancer we can conclude that the sensitivity of 76% indicates it has a 76% probability of diagnosing lung cancer and being the specificity of 100% we can infer that this has a 100% probability of diagnosing patients who do not have lung cancer. More clinical studies are needed to validate this technique in the diagnosis of lung cancer.

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