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Research progress of confocal laser endomicroscopy in malignant respiratory diseases: A review

Zhiliang F, Qian L, Yilian T, Xiang P, Yihui C

Medicine, 2026

Abstract

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.

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