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World J Gastroenterol. Jan 7, 2011; 17(1): 21-27
Published online Jan 7, 2011. doi: 10.3748/wjg.v17.i1.21
Confocal laser endomicroscopy and immunoendoscopy for real-time assessment of vascularization in gastrointestinal malignancies
Dan Ionuţ Gheonea, Tatiana Cârţână, Tudorel Ciurea, Carmen Popescu, Anca Bădărău, Adrian Săftoiu
Dan Ionuţ Gheonea, Tatiana Cârţână, Tudorel Ciurea, Adrian Săftoiu, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, Craiova 200349, Romania
Dan Ionuţ Gheonea, Physiology Department, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest 050474, Romania
Carmen Popescu, Cytology Laboratory, Emergency Hospital Craiova, Craiova 200642, Romania
Anca Bădărău, Physiology Department, University of Medicine and Pharmacy Carol Davila Bucharest, Bucharest 050474, Romania
Author contributions: Gheonea DI and Cârţână T wrote this paper; Ciurea T, Săftoiu A and Gheonea DI designed the research and performed the imaging procedures; Popescu C interpreted the histology images; Bădărău A assisted in the scientific writing of the paper.
Supported by Research Grant, No. 239/2007, entitled OCTEUS, financed by the CNCSIS Romania and by the Sectoral Operational Programme Human Resources Development (SOP HRD), financed from the European Social Fund and by the Romanian Government under the contract number POSDRU/89/1.5/S/64109
Correspondence to: Dan Ionuţ Gheonea, MD, PhD, MSc, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy Craiova, 1 Mai, 66, Craiova, 200639, Romania. digheonea@gmail.com
Telephone: +40-751-268731  Fax: +40-251-310287
Received: September 12, 2010
Revised: October 19, 2010
Accepted: October 26, 2010
Published online: January 7, 2011
Abstract

Gastrointestinal cancers represent a major cause of morbidity and mortality, with incomplete response to chemotherapy in the advanced stages and poor prognosis. Angiogenesis plays a crucial part in tumor growth and metastasis, with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network. Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents. Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination (immunoendoscopy), as a future challenge, will add functional analysis to the morphological aspect of the neoplastic process. This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization, resulting in a broad spectrum of potential clinical applications, and also preclinical research that could be translated to human studies.

Keywords: Confocal laser endomicroscopy; Immunoendoscopy; Fluoresceine; Acriflavine; Cancer