ArticleJournal of thoracic disease2021
Diagnosis of visceral pleural invasion using confocal laser endomicroscopy during lung cancer surgery.
Article in Journal of thoracic disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 12 citations in OpenAlex.
- Research progress of confocal laser endomicroscopy in malignant respiratory diseases: A review.Medicine · 2026Review
- Multi-component radiological model based on intratumoral CT threshold segmentation for predicting visceral pleural invasion in lung adenocarcinoma ≤ 30 mm.Insights into imaging · 2026Article
- Article
- Probe-based confocal laser endomicroscopy imaging features of malignant lung nodules: results from a prospectiveJournal of thoracic disease · 2025Article
- Visible Pleural Retraction is a Prognostic Marker in Early-Stage Non-Small Cell Lung Cancer: A Retrospective Cohort Study.Annals of surgical oncology · 2025Article
- Mini-Invasive Pleural Probe-Based Confocal Laser Endomicroscopy for Malignant Pleural Effusion Diagnosis.Respiration; international review of thoracic diseases · 2025Article
- Advances in early detection of non-small cell lung cancer: A comprehensive review.Cancer medicine · 2024Review
- Prediction of visceral pleural invasion of clinical stage I lung adenocarcinoma using thoracoscopic images and deep learning.Surgery today · 2024Article
- Research progress in predicting visceral pleural invasion of lung cancer: a narrative review.Translational cancer research · 2024Review
- The role of confocal laser endomicroscopy in pulmonary medicine.European respiratory review : an official journal of the European Respiratory Society · 2023Review
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Authors and funding
13 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundVisceral pleural invasion (VPI) in lung cancer is a significant prognostic factor; however, it is difficult to diagnose preoperatively or intraoperatively. In this study, we examined the possibility of intraoperative diagnosis of VPI using confocal laser endomicroscopy (CLE).
methodsAmong patients with primary lung cancer who underwent surgery between April 2018 and August 2019, those in whom the tumor was in contact with the pleura on chest computed tomography and whose pleural changes were intraoperatively confirmed were enrolled in this study. In the 35 patients who underwent lung resection (6 cases with visceral pleural infiltration), the area where pleural change was noted was observed and a short video was recorded using CLE. Based on the video images, three evaluators determined the defect ratio (0%, 25%, 50%, 75%, and 100%) of the autofluorescence-positive structure. The area under the receiver operating characteristic curve was used to evaluate the diagnostic performance for VPI. In 15 cases (3 cases with VPI), a validation study was performed for intraoperative VPI according to the cutoff value of the defect ratio of the autofluorescence-positive structure.
resultsThe areas under the receiver operating characteristic curve for the defect ratio of the autofluorescence-positive structure were 0.86-0.91 for the three readers. Using defect ratio of autofluorescence-positive structure cutoff of ≥50% as predictor of VPI, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 83.3-100.0%, 57.7-73.1%, 35.3-41.7%, 95.0-100.0%, and 75.0-78.1%, respectively, for the three readers. In the validation study, the sensitivity was 100%, the specificity was 83.3%, and the diagnostic accuracy rate was 86.7%.
conclusionsThe diagnosis of VPI through CLE is simple, non-invasive, and has high diagnostic accuracy rates. This method may be applicable for determining surgical procedures.
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