Systematic Reviews
Copyright ©The Author(s) 2015.
World J Gastroenterol. Nov 28, 2015; 21(44): 12696-12708
Published online Nov 28, 2015. doi: 10.3748/wjg.v21.i44.12696
Table 2 Performance of characteristics of findings on confocal laser endomicroscopy for pancreatobiliary strictures
CriterionAuthor and the description of the examined areaSensitivitySpecificityPPVNPV
Meining et al[41,53]
Malignant biliary stricturesLoss of reticular pattern of epithelial bands of less than 20 μm83%88%NRNR
Irregular epithelial lining, villi, or gland-like structures
Tortuous, dilated, and saccular vessels with inconsistent branching
Presence of “black areas” of more than 60 to 80 μm (focally decreased uptake of fluorescein)
Meining et al[20]
Suggestive ofmalignancyThick, dark bands (> 40 μm)98%67%71%97%
Thick, white bands (> 20 μm)
Dark clumps
Epithelium visualized (villi, glands)
Fluorescein leakage
Suggestive ofbenign stricturesThin, dark (branching) bands
Thin, white bands
Meining et al[14]
Normal bile ductsReticular network of thin dark branching bands (< 20 μm)97%33%80%80%
Light gray background
Vessels < 20 μm
Malignant biliary stricturesThick white bands (> 20 μm)
Thick dark bands (> 40 μm),
Dark clumps
Epithelial structures
Normal vessels (thin and regular)
No visible glands
Giovannini et al[18]
Benign IPMNFinger-like projections corresponding to villous changes of intestinal IPMN typeNRNRNRNR
Pancreatic adenocarcinomaVascular leakage with irregular vessels with leakage of fluorescein into the tumor
Large dark clumps which correspond to humps of malignant cells
Benign Lymph nodesDiffuse small cells into a homogeneous stroma with normal vascularization
Malignant lymph nodesGlandular structures with dark cells, large dark clumps and neo-vascularization with huge leakage of fluorescein
Filoche et al[56]
Benign inflammatory strictures of the common bile ductVascular congestion but still regularNRNRNRNR
Roughness aspect
Increased inter-glandular space
Thickened reticular structure
Caillol et al[15]
Inflammatory stenosisMultiple thin white bands (Vascular congestion)96.3%63.6%68.4%95.5%
Roughness aspect
Increased inter-glandular space
Thickened reticular structure