Evaluation of feasibility of confocal laser endomicroscopy for visceral pleural invasion diagnosis of lung cancer

2018 Fiscal Year Final Research Report

• Project/Area Number: 17K16611
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Respiratory surgery
• Research Institution: The University of Tokushima
• Principal Investigator: SAWADA Toru 徳島大学, 病院, 特任助教 (60522258)
• Project Period (FY): 2017-04-01 – 2019-03-31
• Keywords: 呼吸器 / 肺癌 / 胸膜浸潤 / 共焦点レーザー内視鏡 / 自家蛍光

Outline of Final Research Achievements

It is difficult to diagnose visceral pleural invasion (VPI) of non-small cell lung cancer (NSCLC) by preoperative imaging or intraoperative macroscopic findings, and VPI is usually diagnosed by postoperative pathologic examination. Confocal laser endomicroscopy (CLE) is an innovative technique for real-time, non-invasive analysis of the surface epithelium. This ex vivo study was conducted to evaluate the feasibility of CLE diagnosis for VPI of NSCLC. We defined defect of reticulated structure, which is usually observed at normal visceral pleura by CLE, of the pleura at the tumor site as a positive finding of VPI in accordance with our preliminary study. Thirty-five patients were included in the study. The sensitivity, specificity, and accuracy of VPI diagnosis by CLE were 100%, 93%, and 75%, respectively. CLE is feasible to diagnose VPI of NSCLC.

Free Research Field

医歯薬学

Academic Significance and Societal Importance of the Research Achievements

胸膜浸潤の診断は，術後の病理診断によって確定するが，術前または術中に診断できれば術式選択を含む治療方針決定のための有力な情報となる．従来の白色光における術中胸膜浸潤診断は術後最終病理結果を待たなければならないジレンマがあり，診断の精度向上は常に課題にあがる．今回，CLEを用いることで診断精度が向上することにより，今後術式を選択する際，より患者の有益である術式を選択することができる．