Digestive Diseases and Sciences

, Volume 58, Issue 1, pp 188–193 | Cite as

Improved Detection of Incident Dysplasia by Probe-Based Confocal Laser Endomicroscopy in a Barrett’s Esophagus Surveillance Program

  • Helga Bertani
  • Marzio Frazzoni
  • Emanuele Dabizzi
  • Flavia Pigò
  • Luisa Losi
  • Mauro Manno
  • Raffaele Manta
  • Gabrio Bassotti
  • Rita Conigliaro
Original Article



Probe-based confocal laser endomicroscopy (pCLE) is a new technique allowing in vivo detection of neoplastic tissue using a standard endoscope.


Our aim was to compare the incident dysplasia detection rate of biopsies obtained by high-definition white light endoscopy (HD-WLE) or by pCLE in a cohort of patients with Barrett’s esophagus (BE) participating in a surveillance program.


Fifty of 100 patients underwent pCLE in addition to HD-WLE. Four-quadrant biopsy specimens according to the Seattle biopsy protocol were obtained in all patients to ensure standard-of-care. Diagnosis of dysplasia/neoplasia was made by a blinded gastrointestinal pathologist.


Incident high-grade dysplasia (HGD) and low-grade dysplasia (LGD) were diagnosed in 3/100 and in 16/100 cases. In the HD-WLE group, areas suspicious for neoplasia were not observed and dysplasia was diagnosed in 5/50 (10 %) patients (one with HGD). In the pCLE group, areas suspicious for neoplasia were observed by pCLE in 21/50 (42 %) patients; dysplasia was confirmed in 14 cases (28 %) (two with HGD). The dysplasia detection rate was significantly higher in the pCLE group than in the HD-WLE group (P = 0.04). The sensitivity, specificity, positive and negative predictive values of pCLE for dysplasia were 100, 83, 67, and 100 %, respectively.


Incident dysplasia can be more frequently detected by pCLE than by HD-WLE in BE. The higher dysplasia detection rate provided by pCLE could improve the efficacy of BE surveillance programs.


Confocal laser endomicroscopy Barrett’s esophagus Esophageal dysplasia Esophageal adenocarcinoma 


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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Helga Bertani
    • 1
  • Marzio Frazzoni
    • 2
  • Emanuele Dabizzi
    • 1
  • Flavia Pigò
    • 1
  • Luisa Losi
    • 3
  • Mauro Manno
    • 1
  • Raffaele Manta
    • 1
  • Gabrio Bassotti
    • 4
  • Rita Conigliaro
    • 1
  1. 1.Endoscopia DigestivaNuovo Ospedale S. AgostinoModenaItaly
  2. 2.Fisiopatologia Digestiva Nuovo Ospedale S. AgostinoModenaItaly
  3. 3.Anatomia Patologica Ospedale PoliclinicoModenaItaly
  4. 4.Clinica di Gastroenterologia ed EpatologiaPerugiaItaly

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