{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:32:43Z","timestamp":1786984363362,"version":"build-2736575974"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"33","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,8,14]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>The diagnosis and monitoring of malignant respiratory diseases are heavily reliant on imaging techniques and tissue biopsies. Confocal laser endomicroscopy (CLE) is an advanced real-time imaging modality with high resolution, capable of visualizing the morphology and structure of pulmonary tissue in conjunction with conventional bronchoscopy. Within the realm of malignant respiratory diseases, it enables differentiation between normal and abnormal regions in the central airways, lung parenchyma, mediastinal lymph nodes, and pleura. Although CLE has not yet been integrated into routine clinical practice, it has the potential to guide biopsies, thereby enhancing diagnostic yield while mitigating the occurrence of associated complications. Moreover, this technology holds significant potential for elucidating disease pathogenesis, facilitating intraoperative assessment, and monitoring therapeutic efficacy. Looking towards the future, the integration of CLE with artificial intelligence represents a promising direction for the development of this technology. This review encapsulates the latest advancements of CLE in the context of malignant respiratory diseases, with a particular emphasis on its application in the diagnosis and treatment of lung cancer.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1097\/md.0000000000048639","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T18:02:45Z","timestamp":1786730565000},"page":"e48639","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Research progress of confocal laser endomicroscopy in malignant respiratory diseases"],"prefix":"10.1097","volume":"105","author":[{"given":"Fan","family":"Zhiliang","sequence":"first","affiliation":[{"name":"Department of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guizhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guizhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tang","family":"Yilian","sequence":"additional","affiliation":[{"name":"Department of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guizhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pu","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guizhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5542-3858","authenticated-orcid":false,"given":"Chai","family":"Yihui","sequence":"additional","affiliation":[{"name":"Department of Basic Medicine, Guizhou University of Traditional Chinese Medicine, Guizhou, China."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20260817","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.21037\/tlcr-20-808","article-title":"Latest CT technologies in lung cancer screening: protocols and radiation dose reduction.","volume":"10","author":"Vonder","year":"2021","journal-title":"Transl Lung Cancer Res"},{"key":"R2-20260817","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1016\/j.chest.2019.12.024","article-title":"An evaluation of diagnostic yield from bronchoscopy: the impact of clinical\/radiographic factors, procedure type, and degree of suspicion for cancer.","volume":"157","author":"Silvestri","year":"2020","journal-title":"Chest"},{"key":"R3-20260817","doi-asserted-by":"crossref","first-page":"220185","DOI":"10.1183\/16000617.0185-2022","article-title":"The role of confocal laser endomicroscopy in pulmonary medicine.","volume":"32","author":"Tian","year":"2023","journal-title":"Eur Respir Rev"},{"key":"R4-20260817","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1164\/rccm.200605-684OC","article-title":"In vivo imaging of the bronchial wall microstructure using fibered confocal fluorescence microscopy.","volume":"175","author":"Thiberville","year":"2007","journal-title":"Am J Respir Crit Care Med"},{"key":"R5-20260817","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1111\/resp.12578","article-title":"Comparison of in vivo probe-based confocal laser endomicroscopy with histopathology in lung cancer: a move toward optical biopsy.","volume":"20","author":"Wellikoff","year":"2015","journal-title":"Respirology"},{"key":"R6-20260817","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1183\/09031936.00062512","article-title":"Confocal laser endomicroscopy for diagnosing lung cancer in vivo.","volume":"41","author":"Fuchs","year":"2013","journal-title":"Eur Respir J"},{"key":"R7-20260817","first-page":"792","article-title":"Preliminary observation of imaging with confocal laser endoscopic in lung cancer.","volume":"38","author":"Weizhan Luo","year":"2015","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"key":"R8-20260817","doi-asserted-by":"crossref","first-page":"31372","DOI":"10.1038\/srep31372","article-title":"Assessing the utility of autofluorescence-based pulmonary optical endomicroscopy to predict the malignant potential of solitary pulmonary nodules in humans.","volume":"6","author":"Seth","year":"2016","journal-title":"Sci Rep"},{"key":"R9-20260817","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1111\/1759-7714.13089","article-title":"Probe-based confocal laser endomicroscopy for rapid on-site evaluation of transbronchial biopsy specimens.","volume":"10","author":"Takemura","year":"2019","journal-title":"Thorac Cancer"},{"key":"R10-20260817","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.artmed.2014.05.003","article-title":"Scattering features for lung cancer detection in fibered confocal fluorescence microscopy images.","volume":"61","author":"Rakotomamonjy","year":"2014","journal-title":"Artif Intell Med"},{"key":"R11-20260817","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/resp.12326","article-title":"Comparative study of ex vivo probe-based confocal laser endomicroscopy and light microscopy in lung cancer diagnostics.","volume":"19","author":"Sorokina","year":"2014","journal-title":"Respirology"},{"key":"R12-20260817","doi-asserted-by":"crossref","first-page":"e0180576","DOI":"10.1371\/journal.pone.0180576","article-title":"In- and ex-vivo molecular imaging of apoptosis to assess sensitivity of non-small cell lung cancer to EGFR inhibitors using probe-based confocal laser endomicroscopy.","volume":"12","author":"Guisier","year":"2017","journal-title":"PLoS One"},{"key":"R13-20260817","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.7150\/jca.84220","article-title":"Application of bronchoscopy in the diagnosis and treatment of peripheral pulmonary lesions in China: a national cross-sectional study.","volume":"14","author":"Huang","year":"2023","journal-title":"J Cancer"},{"key":"R15-20260817","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s00408-015-9769-8","article-title":"A novel method for in vivo imaging of solitary lung nodules using navigational bronchoscopy and confocal laser microendoscopy.","volume":"193","author":"Hassan","year":"2015","journal-title":"Lung"},{"key":"R16-20260817","first-page":"235","article-title":"EUS-guided needle-based confocal laser endomicroscopy: a novel technique with emerging applications.","volume":"11","author":"Bhutani","year":"2015","journal-title":"Gastroenterol Hepatol"},{"key":"R17-20260817","doi-asserted-by":"crossref","first-page":"e10","DOI":"10.1164\/rccm.201603-0657IM","article-title":"Real-time optical biopsy of lung cancer.","volume":"194","author":"Wijmans","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"key":"R18-20260817","doi-asserted-by":"crossref","first-page":"2608","DOI":"10.21037\/jtd.2017.06.10","article-title":"Needle-based confocal laser endomicroscopy in the diagnosis of peripheral pulmonary nodule: a preliminary report.","volume":"9","author":"Su","year":"2017","journal-title":"J Thorac Dis"},{"key":"R19-20260817","doi-asserted-by":"crossref","first-page":"1801520","DOI":"10.1183\/13993003.01520-2018","article-title":"Needle-based confocal laser endomicroscopy for real-time diagnosing and staging of lung cancer.","volume":"53","author":"Wijmans","year":"2019","journal-title":"Eur Respir J"},{"key":"R20-20260817","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1136\/thoraxjnl-2021-216885","article-title":"Bronchoscopic needle-based confocal laser endomicroscopy (nCLE) as a real-time detection tool for peripheral lung cancer.","volume":"77","author":"Kramer","year":"2022","journal-title":"Thorax"},{"key":"R21-20260817","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1159\/000522515","article-title":"Robotic navigational bronchoscopy combined with needle-based confocal laser endomicroscopy: case report of a novel approach to diagnose small lung nodules.","volume":"101","author":"Manley","year":"2022","journal-title":"Respiration"},{"key":"R22-20260817","doi-asserted-by":"crossref","first-page":"2002537","DOI":"10.1183\/13993003.02537-2020","article-title":"Solitary pulmonary nodule imaging approaches and the role of optical fibre-based technologies.","volume":"57","author":"Fernandes","year":"2021","journal-title":"Eur Respir J"},{"key":"R23-20260817","doi-asserted-by":"crossref","first-page":"4194","DOI":"10.1007\/s00259-022-05868-9","article-title":"Targeted detection of cancer cells during biopsy allows real-time diagnosis of pulmonary nodules.","volume":"49","author":"Kennedy","year":"2022","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"R24-20260817","first-page":"E17","article-title":"Endoscopic ultrasound-guided needle-based confocal laser endomicroscopy for diagnosis of solid pancreatic lesions (ENES): a pilot study.","volume":"4","author":"Kongkam","year":"2016","journal-title":"Endosc Int Open"},{"key":"R25-20260817","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.rmed.2019.01.006","article-title":"First report of probe based confocal laser endomicroscopy during medical thoracoscopy.","volume":"147","author":"Bonhomme","year":"2019","journal-title":"Respir Med"},{"key":"R26-20260817","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/j.chest.2019.04.090","article-title":"Confocal laser endomicroscopy as a guidance tool for pleural biopsies in malignant pleural mesothelioma.","volume":"156","author":"Wijmans","year":"2019","journal-title":"Chest"},{"key":"R27-20260817","doi-asserted-by":"crossref","first-page":"5437","DOI":"10.12659\/MSM.909989","article-title":"Confocal laser endomicroscopy for diagnosing malignant pleural effusions.","volume":"24","author":"Zirlik","year":"2018","journal-title":"Med Sci Monit"},{"key":"R28-20260817","doi-asserted-by":"crossref","first-page":"101620","DOI":"10.1016\/j.media.2019.101620","article-title":"Image computing for fibre-bundle endomicroscopy: a review.","volume":"62","author":"Perperidis","year":"2020","journal-title":"Med Image Anal"},{"key":"R29-20260817","doi-asserted-by":"crossref","first-page":"7","DOI":"10.21037\/tgh.2020.04.02","article-title":"Confocal laser endomicroscopy in gastro-intestinal endoscopy: technical aspects and clinical applications.","volume":"7","author":"Pilonis","year":"2022","journal-title":"Transl Gastroenterol Hepatol"},{"key":"R30-20260817","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"R31-20260817","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.1440-1746.2007.05221.x","article-title":"Confocal endomicroscopy for in vivo detection of microvascular architecture in normal and malignant lesions of upper gastrointestinal tract.","volume":"23","author":"Liu","year":"2008","journal-title":"J Gastroenterol Hepatol"},{"key":"R32-20260817","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1159\/000320365","article-title":"Fluorescein-aided confocal laser endomicroscopy of the lung.","volume":"81","author":"Fuchs","year":"2011","journal-title":"Respiration"},{"key":"R33-20260817","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s12890-015-0020-4","article-title":"Safety and performance analysis of acriflavine and methylene blue for in vivo imaging of precancerous lesions using fibered confocal fluorescence microscopy (FCFM): an experimental study.","volume":"15","author":"Obstoy","year":"2015","journal-title":"BMC Pulm Med"},{"key":"R34-20260817","doi-asserted-by":"crossref","first-page":"10966","DOI":"10.1039\/C9RA00954J","article-title":"High resolution tracking of macrophage cells in deep organs and lymphatics using fluorescent polymer dots.","volume":"9","author":"Tang","year":"2019","journal-title":"RSC Adv"},{"key":"R35-20260817","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s12890-018-0760-z","article-title":"Real-time molecular optical micro-imaging of EGFR mutations using a fluorescent erlotinib based tracer.","volume":"19","author":"Patout","year":"2019","journal-title":"BMC Pulm Med"},{"key":"R36-20260817","first-page":"1417","article-title":"Ex vivo fluorescence confocal microscopy meets innovation and revolutionary technology, for \u201creal-time\u201d histological evaluation, in pediatric surgical oncology.","volume":"11","author":"Di Fabrizio","year":"2024","journal-title":"Children (Basel)"},{"key":"R37-20260817","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1093\/icvts\/ivab135","article-title":"Confocal endomicroscopy and robot-assisted bronchoplasty integration to treat an endobronchial tumour.","volume":"33","author":"Terra","year":"2021","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"R38-20260817","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/MCP.0000000000000842","article-title":"Bronchoscopic diagnosis of peripheral lung lesions.","volume":"28","author":"Gasparini","year":"2022","journal-title":"Curr Opin Pulm Med"},{"key":"R39-20260817","doi-asserted-by":"crossref","first-page":"e0189846","DOI":"10.1371\/journal.pone.0189846","article-title":"Assessing the feasibility of confocal laser endomicroscopy in solitary pulmonary nodules for different part of the lungs, using either 0.6 or 1.4\u2009mm probes.","volume":"12","author":"Hassan","year":"2017","journal-title":"PLoS One"},{"key":"R40-20260817","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1111\/resp.14438","article-title":"Robotic bronchoscopic needle-based confocal laser endomicroscopy to diagnose peripheral lung nodules.","volume":"28","author":"Manley","year":"2023","journal-title":"Respirology"},{"key":"R41-20260817","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1055\/s-0042-109775","article-title":"Needle-based confocal endomicroscopy for evaluation of malignant lymph nodes \u2013 a feasibility study.","volume":"48","author":"Benias","year":"2016","journal-title":"Endoscopy"},{"key":"R42-20260817","doi-asserted-by":"crossref","first-page":"4742","DOI":"10.21037\/jtd-21-137","article-title":"Diagnosis of visceral pleural invasion using confocal laser endomicroscopy during lung cancer surgery.","volume":"13","author":"Sawada","year":"2021","journal-title":"J Thorac Dis"}],"container-title":["Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000048639","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T16:01:40Z","timestamp":1786982500000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/MD.0000000000048639"}},"subtitle":["A review"],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":41,"journal-issue":{"issue":"33","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/md.0000000000048639","relation":{},"ISSN":["0025-7974","1536-5964"],"issn-type":[{"value":"0025-7974","type":"print"},{"value":"1536-5964","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"assertion":[{"value":"2025-01-01","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}