共聚焦激光显微内镜对慢性萎缩性胃炎定量诊断的价值  

Value of confocal endoscopy in the quantitative diagnosis of chronic atrophic gastritis

作　　者：柯杰 计春燕 计承承 王庆新 周健 KE Jie;JI Chunyan;JI Chengcheng;WANG Qingxin;ZHOU Jian(Hubei University of Chinese Medicine,Wuhan 430065;Department of Gastroenterology,Hubei Provincial Hospital of Integrated Traditional Chinese and Western Medicine,China)

机构地区：[1]湖北中医药大学,湖北武汉430065 [2]湖北省中西医结合医院消化内科

出　　处：《胃肠病学和肝病学杂志》2025年第2期240-243,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：省卫生健康委科研项目立项合同书(WJ2023F029)。

摘　　要：目的基于探头的共聚焦激光显微内镜(probe-based confocal laser endomicroscopy,pCLE)观察腺体微观结构,分析对慢性萎缩性胃炎(chronic atrophic gastritis,CAG)、肠上皮化生(intestinal metaplasia,IM)的诊断效果。方法随机选择湖北省中西医结合医院20例已确诊CAG患者,分别予以白光内镜、pCLE及内镜活检检查。分析pCLE下,CAG患者的腺体特点。结果胃黏膜萎缩后,pCLE观察可见胃小凹稀疏,胃小凹数<5个;腺体间距增宽,平均腺体间距>36.33μm;萎缩及IM可见新生血管增多,IM多可见杯状细胞。pCLE下依据萎缩及IM的诊断特点,与组织学诊断结果符合率分别可达84.62%、87.50%。结论pCLE下以胃小凹数<5个,腺间距离>36.33μm,杯状细胞及刷状缘可作为IM的诊断依据;CAG伴IM患者新生血管增多,四方面作为定量诊断标准,对CAG和IM的诊断敏感性高。Objective To observe the microscopic structure of glands using probe-based confocal laser endomicroscopy(pCLE)and analyze its diagnostic efficacy for chronic atrophic gastritis(CAG)and intestinal metaplasia(IM).Methods Twenty patients with confirmed CAG were randomly selected,confocal laser endoscopy and endoscopic biopsy.The gland characteristics of CAG patients under confocal laser endoscopy were analyzed.Results After gastric mucosa atrophy,pCLE showed<5;gland spacing widened,gland spacing>36.33μm.Neovascularization was increased in atrophy and intestinal with more goblet cells.According to the diagnostic characteristics of atrophy and enterization under confocal endoscopy,the coincidence rate with the histological diagnostic results could reach 84.62%and 87.50%,respectively.Conclusion Gastric pits<5 and gland spacing>36.33μm;glandular cells and brush border were used as the diagnostic basis of IM.CAG and IM patients have high diagnostic sensitivity to CAG and IM.

关 键 词：共聚焦激光显微内镜 萎缩性胃炎 肠上皮化生 癌前病变 

分 类 号：R57[医药卫生—消化系统]