Role of Confocal Laser Scanning Microscopy for the Detection of Cervical Cancer

Cervical cancer is a major health issue in developing countries. Early diagnosis and treatment of the disease play a crucial role in the healthcare industry. At present, the diagnostic methods have limitations; newer technologies and techniques are developing, and confocal microscopy is one of them. Classification of cervical precancer stages and treatment is currently based on histopathological classification which has limits due to inter- and intra-variable observation. Confocal microscopy detects cervical precancerous lesions automatically in a non-invasive manner as a point-of-care technology which in turn benefits patient care with limited follow-up procedures. This review encompasses the advantage of confocal microscopy over the current diagnostic techniques.

Optical methods are proving more appropriate to indicate changes associated with tissue including cell morphology, metabolic activity and differentiation, stromal angiogenesis, as well as epithelial–stromal communication. Digital image analysis techniques identify and focus on the abnormal areas with high sensitivity. Suspicious regions can be further confirmed using high-resolution techniques. Quantitative analysis of confocal fluorescence images discriminates high-grade Cervical Intra-epithelial Neoplasia (CIN) lesions versus low-grade CIN lesions and normal tissues, at various depths of imaging.

Portable and cost-effective models of confocal microscopy are under trial phase which would be used for primary screening in a real-time manner especially in low- and middle-income countries in future.