数字染色内镜及共聚焦激光显微内镜在Barrett食管诊断中的价值研究  

Digital chrome endoscopy and confocal laser endomicroscopy in diagnosis of Barrett esophagus

作　　者：龙沛琪[1] 岳辉[1] 王伟飞[1] 魏清柱[2] 毛正果[1] 邓三花[1] 彭芊芊[1] 

机构地区：[1]南方医科大学第三附属医院消化内科,广州510630 [2]南方医科大学第三附属医院病理科,广州510630

出　　处：《中华消化内镜杂志》2011年第12期688-691,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨数字染色内镜（I-Scan）及共聚焦激光显微内镜（CLE）对Barrett食管（BE）的诊断价值。方法878例患者行普通内镜和I-Scan模式下检查，部分筛查出的疑似BE患者行CLE检查及活检，比较普通内镜和I-Scan模式下疑似BE检出率及图象特点，对比分析活检病理及CLE诊断BE结果。结果普通胃镜模式下筛查出疑似BE患者46例（5．2％），I-Scan筛查出52例（5．9％），两者比较差异无统计学意义（x2=0．533，P〉0．05）；普通胃镜模式下SCJ与CEJ间距间可观察到栅栏状血管者21例（45．7％），I-Scan可观察到35例（67．3％），两者比较差异有统计学意义（X2=0．031，P〈0．05）。19例疑似BE患者进行了CLE检查及活检，CLE诊断BE的敏感度、特异度分别为93％和100％。结论I-Scan对SCJ与GEJ间距间栅栏状血管的观察具有重要意义，可提高疑似BE检出率；CLE使实时在体组织学诊断成为可能，诊断BE的敏感度和特异度均较高。Objective To evaluate digital chrome endoscopy （I-Scan） and confocal laser endomieroscopy （CLE） for diagnosis of Barrett esophagus （BE）. Methods From July 2010 to July 2011, a total of 878 outpatients who had upper gastrointestinal symptoms underwent routine endoscopy and I-Scan examination, screened patients with suspected Barrett＇s epithelial were further referred to CLE and endoscopy. The detection rate and image features of BE between routine endoscopy and I-Scan, and the diagnosis of BE be- tween pathology and CLE, were compared respectively. Results Suspected BE was diagnosed in 46 patients （5.2%） by routine endoscopy, and in 52 （5.9%） by I-Scan, and there was no significant difference in detection rate between 2 methods （X2 = 0. 533, P 〉 0. 05 ）. The detection rate of paliform blood vessels between SCJ and GEJ was higher using I-Scan （35/52, 67.3% ） than routine endoscope （21/46, 45.7% , P 〈0. 05）. A total of 19 suspected BE underwent CLE and biopsy, and BE was diagnosed by CLE with a sensitivity of 93% and a specificity of 100%. Conclusion I-Scan is capable of identifying paliform blood vessels between SCJ and GEJ, and can improve the detection rate of suspected BE. CLE is able to provide in-vivo histological diagnosis of BE with a high sensitivity and specificity.

关 键 词：BARRETT食管 诊断 数字染色内镜 共聚焦激光显微内镜 

分 类 号：R571[医药卫生—消化系统]