Barrett食管的色素放大内镜分型与组织学分型相关性的临床研究  

Correlation between Magnifying Chromoendoscopic Classification and Histological Type of Barrett’s Esophagus:a Clinical Study

作　　者：高娜[1] 王彩霞[2] 刘明华[1] 王孟春[1] 

机构地区：[1]中国医科大学附属盛京医院消化内科,沈阳110004 [2]中国医科大学附属盛京医院内镜中心,沈阳110004

出　　处：《中国医科大学学报》2009年第6期465-467,共3页Journal of China Medical University

摘　　要：目的通过研究Barrett食管的色素放大内镜分型、组织学分型及两者相关性,为Barrett食管提供一种简便的内镜监测手段。方法42例接受常规内镜检查的Barrett食管患者,用美蓝对其黏膜进行染色并行放大内镜观察记录黏膜类型,同时活检取材进行HE染色确定组织学分型。结果42例Barrett食管中,美蓝着色者14例其组织类型全部为特殊肠化型;美蓝不着色者28例其中26例为胃底型,2例为胃贲门交界型。放大内镜下小凹形态呈点状者21例,其中15例为胃底型,6例为交界型,无特殊肠化型;短棒状者24例,其中17例为胃底型,6例为胃贲门交界型,1例为特殊肠化型;绒毛型12例和不规则型1例其组织病理类型全部为特殊肠化型。结论美蓝染色是一种能够判定Barrett食管上皮化生类型的方法,而放大内镜下的不同表现也可初步判定Barrett食管上皮化生类型,检查结果与组织学检查结果吻合。Objective To study the correlation between magnifying chromoendoscopic classification and histologic type of Barrett＇s esophagus and thus provide a convenient endoscopic surveillance method for Barrett＇s esophagus. Methods A total of 42 patients with Barrett＇s esophagus who underwent conventional endoscopy were enrolled in this study. The esophageal mucosa was stained with methylene blue, and magnifying chromoendoscopy was performed to identify the mucosa pattern. The esophageal tissue was sampled and stained with HE to identified the histological type. Results Among 42 patients with Barrett＇s esophagus, the histological type of methylene blue stained mucosa of 14 patients was specialized intestinal metaplasia. Among 28 patients with methylene blue unstained mucosa,the histological type was gastric epithelium in 26 and cardiac epithelium in 2. Among 21 patients with pit pattern under magnifying endoscope,gastric epithelium was found in 15 and cardiac epithelium in 6. Among 24 patients with straight pattern under magnifying endoscope, gastric epithelium was found in 17, cardiac epithelium in 6, and specialized intestinal metaplasia in 1. The histopatholical types of 12 patients with villous pattern and 1 with irregular pattern were all specialized intestinal metaplasia. Conclusion Chmmoendoscopy with mythylene blue staining might be an effective way to identify the metaplasia pattern of Barrett＇s esophagus, and the different manifestations under magnifying endoscope might contribute to preliminary identification of the metaplasia pattern of Barrett＇s esophagus. The results of magnifying chromoendoscopy are consistent with those of histological examination.

关 键 词：BARRETT食管 色素放大内镜 组织学 

分 类 号：R571[医药卫生—消化系统]