Disruptive solution of medical endoscopy in integrated diagnosis and treatment of tumors

1、 Breakthrough technology for early diagnosis of tumors

(1) Molecular Imaging Endoscopy

Technological disruption:

Targeted fluorescent probes, such as EGFR antibody Cy5.5 markers, specifically bind to early gastrointestinal cancer (sensitivity 92% vs white light endoscopy 58%).

Confocal Laser Microendoscopy (pCLE): Real time observation of cellular atypia at 1000x magnification, with a diagnostic accuracy of 95% for Barrett's esophagus cancer.

Clinical case:

The National Cancer Center of Japan used 5-ALA induced fluorescence to detect early gastric cancer lesions<1mm.

(2) Real time AI assisted diagnostic system

Technical implementation:

Deep learning algorithms such as Cosmo AI automatically label polyps during colonoscopy, resulting in a 27% increase in adenoma detection rate (ADR).

Ultrasound endoscopy (EUS) combined with AI to differentiate the malignant risk of pancreatic cysts (AUC 0.93 vs expert 0.82).

2、 Revolutionary solution for precise minimally invasive treatment

(1) Intelligent upgrade of endoscopic submucosal dissection (ESD)

Technological breakthrough:

3D optical topology imaging: Olympus EVIS X1 system displays real-time submucosal vascular course, reducing bleeding by 70%.

Nanoknife assisted ESD: Irreversible electroporation (IRE) treatment of intrinsic muscle layer infiltration lesions, preserving deep structural integrity.

Efficacy data:

(2) Endoscopic ultrasound radiofrequency ablation (EUS-RFA) triple therapy

Technology integration:

The radiofrequency electrode was introduced into the 19G puncture needle, and the pancreatic cancer was ablated under the guidance of EUS (the local control rate was 73% ≤ 3cm tumor).

Combining drug loaded nano bubbles (such as paclitaxel perfluoropentane) to achieve the integration of "observation treatment drug".

(3) Fluorescence guided lymph node dissection

ICG near-infrared imaging:

Indocyanine green was injected 24 hours before surgery, and endoscopic examination showed sentinel lymph nodes in gastric cancer (detection rate of 98%).

Data from the University of Tokyo: Non essential lymph node dissection decreased by 40%, and the incidence of postoperative lymphedema decreased from 25% to 3%.

3、 Postoperative monitoring and recurrence warning

(1) Liquid Biopsy Endoscopy

Technical highlights:

Perform ctDNA methylation analysis on endoscopic brush samples (such as SEPT9 gene) to predict the risk of recurrence (AUC 0.89).

Microfluidic chip integrated endoscopy: Real time detection of circulating tumor cells (CTCs) in abdominal lavage fluid.

(2) Absorbable marking clip system

Technological innovation:

Magnesium alloy clips were used to mark tumor margins (such as OTSC Pro), and degradation occurred 6 months after surgery. CT follow-up showed no artifacts.

Compared to titanium clips: MRI compatibility improved by 100%.

4、 Multidisciplinary Joint Innovation Program

(1) Endoscopic laparoscopic hybrid surgery (Hybrid NOTES)

Technical combination:

Resection of tumors (such as rectal cancer) through natural endoscopic approach, combined with single port laparoscopy for lymph node dissection.

Data from Peking University Cancer Center: Surgery time reduced by 35%, anal preservation rate increased to 92%.

(2) Proton therapy endoscopic navigation

Technical implementation:

Endoscopic placement of gold tags+CT/MRI fusion, precise tracking of esophageal cancer displacement with proton beam (error<1mm).

5、 Future technological directions

(1) DNA nanorobot endoscope:

The "origami robot" developed by Harvard University can carry thrombin to accurately seal tumor blood vessels.

(2) Metabolomics real-time analysis:

Endoscopic integrated Raman spectroscopy is used to identify tumor metabolic fingerprints (such as choline/creatine ratio) during surgery.

(3) Immunotherapy response prediction:

PD-L1 fluorescent nanoprobes (experimental stage) for predicting the efficacy of gastric cancer immunotherapy.

Clinical Benefit Comparison Table

Implementation path suggestions

Early cancer screening center: equipped with molecular fluorescence endoscopy and AI assisted diagnostic system.

Tumor specialized hospital: construction of EUS-RFA hybrid operating room.

Research breakthrough: Developing tumor specific probes (such as Claudin18.2 targeted fluorescence).

These technologies are driving tumor diagnosis and treatment into the era of "precision closed-loop" through three major breakthroughs: molecular level diagnosis, sub millimeter level treatment, and dynamic monitoring. It is expected that by 2030, 70% of local treatments for solid tumors will be led by endoscopy.