RESUMO
AIM: To analyze the value of confocal laser endomicroscopy in diagnostics of upper gastrointestinal tract mucosa changes in children. PATIENTS AND METHODS: In the current study a total of 116 children aged from 3 to 18 years old undergo conventional endoscopy with confocal laser endomicroscopy supplemented with mucosal biopsy followed by traditional histology in the period from 2011 until 2014. To determine the prognostic value of the of probe based CLE in the evaluation of normal and pathological changes of the esophageal mucosa a comparison of results of optical biopsy with the data obtained during the standard histological examination were performed. RESULTS: After results of probe-based CLE and traditional histology were comprised optical biopsy showed 88.8% sensitivity and 88.3% specificity to esophagitis with Spearmen correlation 0.79 (p = 0.001); 92.3% sensitivity and 95.3% specificity to metaplastic changes of esophageal mucosa with Spearmen correlation 0.85 (p = 0.001); 92.4% sensitivity and 95.2% specificity in differential diagnosis of esophageal polyps with Spearmen correlation 0.95 (p = 0.001). CONCLUSION: Confocal endomicroscopy may become one of the leading methods in pediatric gastroenterology since it allows the endoscopists to inspect the mucosa at the cellular level during the endoscopic procedure and can help in establishing the diagnosis.
Assuntos
Endoscopia do Sistema Digestório/métodos , Doenças do Esôfago/patologia , Esôfago/patologia , Microscopia Confocal/métodos , Adolescente , Biópsia , Criança , Pré-Escolar , Interpretação Estatística de Dados , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Microscopia de Vídeo/métodos , Mucosa/patologia , Valor Preditivo dos Testes , Sensibilidade e EspecificidadeRESUMO
In this review history, principles, technique and clinical applications of confocal laser endomicroscopy are briefly described. This technology allows to expand the diagnostic ability of traditional white light endoscopy and to assess effectiveness of therapeutic procedures in different gastrointestinal diseases. New experimental and clinical data in assessing small bowel barrier dysfunction as a predictor of relapse for inflammatory bowel disease is presented. Problems and perspectives regarding application of optical biopsy for gastrointestinal tract in pediatric practice are discussed.
