Barrett食管在增强放大内镜下黏膜象与病理关系的研究  

Relationship between mucosal surface patterns under enhanced magnification endoscopy and pathological epithelial types of Barrett esophagus

作　　者：梅凡[1] 田德安[1] 但自力[1] 柯昌庶[1] 覃华[1] 廖家智[1] 王波[1] 吴小力[1] 张琼[1] 何春萍[1] 

机构地区：[1]华中科技大学附属武汉同济医院消化内科,武汉430030

出　　处：《中华消化内镜杂志》2007年第6期406-409,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨增强放大内镜对 Barrett 食管的诊断价值。方法对40例疑诊为 Barrett 食管的患者使用2%～3%乙酸喷洒于食管下端,然后使用放大内镜观察并根据黏膜象进行活检。所有活检切片均由高年资病理专家在单盲情况下进行阅片。结果参考2003年 Toyoda 在增强放大内镜下的分型黏膜象共有3型:Ⅰ型小圆型7例(17.5%),其中5例病理为胃底型(71.4%);Ⅱ型网格型24例(60.0%),其中16例病理为胃底型(66.7%);Ⅲ型脑回/绒毛型9例(22.5%),病理均为肠上皮化生或异型增生。Ⅲ型黏膜象与病理的符合率高。结论使用增强放大内镜对食管远端进行详细黏膜象观察与病理检查结果有较高符合率,有助于对 Barrett 食管肠上皮化生和异型增生的诊断。Objective To evaluate the enhanced magnification endoscopy in the diagnosis of Barrett esophagus, and to explore the relationship between mucosal surface patterns and pathological epithelial types of Barrett esophagus. Methods Enhanced magnification endoscopy was performed after spraying 2% - 3% acetic acid on the surface of distal esophagus in 40 Barrett esophagus patients. Mucosal specimen were biopsyed. Results According to the mucosal types of Toyoda in 2003, there were three mucosal types ： Ⅰ dot pattern 7 （ 17.5 % ）, 5 of 7 （71.4% ） fundic type, Ⅱ reticular pattern 24 （60.0%）, 16 of 24 （66.7 % ） fundic type, Ⅲ cerebroid/villous 9（22.5% ）, intestinal metaplasia or dysplasia. Conclusion Enhanced magnification endoscopy helps to identify areas with intestinal metaplasia and dysplasia, and is useful in the diagnosis of Barrett esophagus.

关 键 词：BARRETT食管 增强放大内镜 肠上皮化生 异型增生 

分 类 号：R571[医药卫生—消化系统]