Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2024; 12(26): 5845-5849
Published online Sep 16, 2024. doi: 10.12998/wjcc.v12.i26.5845
Confocal laser endomicroscopy as a new diagnostic tool for poorly differentiated gastric adenocarcinoma
Giuseppe Evola, Marco Vacante, Francesco R Evola
Giuseppe Evola, Department of Surgery, "Garibaldi" Hospital, Catania 95100, Italy
Marco Vacante, Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania 95123, Italy
Francesco R Evola, Department of Surgery, Division of Orthopedics and Trauma Surgery, “Cannizzaro” Hospital, Catania 95100, Italy
Author contributions: Evola G, Vacante M, and Evola FR contributed to this paper; Evola G and Vacante M designed the overall concept and outline of the manuscript; Evola FR contributed to the discussion and design of the manuscript; Evola G, Vacante M, and Evola FR contributed to the writing and editing of the manuscript and illustrations as well as a review of the literature.
Conflict-of-interest statement: Evola G, Vacante M and Evola FR have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe Evola, MD, PhD, Former Contract Professor, Department of Surgery, "Garibaldi" Hospital, Piazza Santa Maria di Gesù n. 5 Catania 95100, Italy. giuseppe_evola@hotmail.it
Received: March 20, 2024
Revised: May 7, 2024
Accepted: June 5, 2024
Published online: September 16, 2024
Processing time: 121 Days and 22.1 Hours
Abstract

Gastric cancer (GC) is a multifactorial disease, where both environmental and genetic features can have an impact on its occurrence and development. GC represents one of the leading causes of cancer-related deaths worldwide. GC is most frequent in males and is believed to arise from a series of premalignant lesions. The detection of GC at an early stage is crucial because early GC, which is an invasive stomach cancer confined to the mucosal or submucosal lining, may be curable with a reported 5-year survival rate of more than 90%. Advanced GC usually has a poor prognosis despite current treatment standards. The diagnostic efficacy of conventional endoscopy (with light endoscopy) is currently limited. Confocal laser endomicroscopy is a novel imaging technique that allows real-time in vivo histological examination of mucosal surfaces during endoscopy. Confocal laser endomicroscopy may be of great importance in the surveillance of precancerous gastric lesions and in the diagnosis of GC. In this editorial we commented on the article about this topic published by Lou et al in the recent issue of the World Journal of Clinical Cases.

Keywords: Confocal laser endomicroscopy, In vivo microscopy, Optical histology, Helicobacter pylori, Intestinal metaplasia, Gastric atrophy, Gastric cancer, Early gastric cancer

Core Tip: Gastric cancer (GC) is one of the leading causes of death worldwide. Conventional white light endoscopy has a limited ability to detect GC and precancerous gastric lesions. Confocal laser endomicroscopy is an endoscopic modality developed to obtain very high magnification and resolution images of the mucosal layer of the gastrointestinal tract. Confocal laser endomicroscopy represents a substantial advancement in endoscopic imaging, as it may allow a direct histological observation of the in vivo tissue without the need for biopsy. Several studies have reported the value of this technique in the diagnosis of precancerous gastric lesions and early GC.