Evidence map›Paper›PMID 42122131›Full record

ReviewCancers2026

Integrating Advanced Endoscopic Techniques and Confocal Microscopy for Early Detection of Extrahepatic Cholangiocarcinoma.

Barbara Lattanzi, Francesco Covotta, Anna Crescenzi, Antonietta Lamazza, Francesco Maria Di Matteo, Domenico Alvaro, Vincenzo Cardinale

Abstract readReview
In one paragraph

Review in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Barbara LattanziDepartment of Gastroenterology and Endoscopy, Pertini Hospital, 00157 Rome, Italy.ORCID 0000-0003-2685-6504
Francesco CovottaDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.
Anna CrescenziDepartment of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University of Rome, 00161 Rome, Italy.ORCID 0000-0002-8156-5753
Antonietta LamazzaDepartment of Surgery, Sapienza University of Rome, 00185 Rome, Italy.
Francesco Maria Di MatteoDigestive Endoscopy Unit, Campus Bio-Medico University Hospital, 00128 Rome, Italy.
Domenico AlvaroDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.ORCID 0000-0003-3771-9644
Vincenzo CardinaleDepartment of Translational and Precision Medicine, Sapienza University of Rome, 00185 Rome, Italy.ORCID 0000-0003-0234-3341

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Extrahepatic cholangiocarcinoma (eCCA) is a highly aggressive malignancy arising from the biliary epithelium, with surgical resection representing the only potentially curative treatment. The predominant periductal infiltrating growth pattern, characterized by subepithelial tumor spread and desmoplastic stromal reaction, severely limits the diagnostic sensitivity of conventional endoscopic sampling techniques, which primarily assess the luminal mucosal surface. This review provides a histomorphology-oriented diagnostic framework for indeterminate extrahepatic biliary strictures, integrating advanced endoscopic technologies with emerging optical diagnostic approaches. ERCP combined with cholangioscopy demonstrates superior sensitivity for perihilar strictures, while EUS-guided tissue acquisition shows higher diagnostic yield in distal cholangiocarcinoma, also providing locoregional staging. Advanced EUS technologies-including elastography, contrast harmonic EUS, and Detective Flow Imaging-further improve characterization of indeterminate strictures by evaluating tissue stiffness, microvascular architecture, and periductal infiltration. Ex vivo fluorescence confocal laser microscopy (FCM) enables real-time microscopic evaluation of biopsy specimens, reducing diagnostic turnaround time and minimizing inadequate sampling. A location-adapted diagnostic algorithm integrating cross-sectional imaging, ERCP, cholangioscopy, and EUS is proposed. An integrated, biology-informed endoscopic approach tailored to tumor location and ductal wall involvement may significantly improve early eCCA detection and guide patient selection for curative treatment.

Indexed as

confocal microscopyendoscopic retrograde cholangiopancreatographyendoscopic ultrasoundextrahepatic cholangiocarcinoma

Identifiers

PMID42122131
PMCPMC13162643

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.