In Vivo Diagnosis of Small-Cell Lung Cancer by Endocytoscopy

In Vivo Diagnosis of Small-Cell Lung Cancer by EndocytoscopySmall-cell lung cancers (SCLCs) represent approximately 13% of all newly diagnosed lung cancers and are characterized by an aggressive course with early locoregional and distant metastases.Prognosis is poor, ranging from 20 months in limited disease to 8 months in extensive disease.Various studies 1,2 have shown that disease stage is the most powerful prognostic factor of SCLC.Therefore, different scoring systems that include physical, biochemical, and radiologic markers have been established.1,2 Despite ongoing developments in bronchoscopy, including innovative powerful endoscopes with new optical enhancement techniques such as narrow band imaging or autofluorescence bronchoscopy, final diagnosis of SCLC remained a field of histopathology.Recently, endocytoscopy was introduced, enabling microscopic imaging of the mucosal layer of the gut at magnifications up to ϫ1,400.3 Endocytoscopy is based on a contact light microscope which enables real-time visualization of cellular structures of the superficial epithelial layer.Currently, endoscopy-based and probe-based systems are available.Probe-based systems consist of handheld miniprobes, which are capable of being inserted through the accessory channel of a standard endoscope.The device provides magnification imaging at ϫ570 or ϫ1,400 on a 19-inch monitor from an optical sampling site of about 0.5 mm in diameter.3 Different studies suggest that endocytoscopy has the potential for in vivo evaluation of duodenal mucosa in celiac disease.4,5 Furthermore, endocytoscopy was able to detect tissue abnormalities in normal mucosa surrounding colorectal cancer and to identify neoplasia in