摘要
目的早期发现和诊断Barrett食管（BE）中的特殊肠上皮化生（肠化）细胞等癌前病变。方法选择2006年4月至11月问29例经胃镜检查确诊为内镜BE的患者，按普通内镜、内镜窄带成像技术（NBI）、内镜靛胭脂染色加放大技术的顺序进行观察，评价各检查方法图像的清晰度；操作医生对NBI下观察到的BE黏膜腺管开口形态进行Endo分型，于改变最显著部位取活检进行病理检查，以明确特殊肠化的检出率。结果在观察鳞一柱状上皮交界的病变轮廓清晰度方面，普通内镜、染色和NBI内镜之间均有统计学差异，其中NBI最清晰，染色次之；在对BE黏膜的腺管开口形态观察中，NBI及内镜染色显著优于普通内镜；在对浅表毛细血管的观察中，NBI具有绝对优势。NBI下根据Endo分型，其Ⅳ型及V型腺管开口形态检出特殊肠化生的准确性达93％，敏感性及特异性分别达89％及95％。结论NBI作为一种新型的内镜检查系统，不仅操作简单，对病变轮廓显示清晰，更可清晰观察到BE黏膜腺管开口及浅表毛细血管结构形态，对BE食管进行靶向病理活检具有良好指导意义和临床实用价值。
Objective To early detect the precancerous lesion of specialized intestinal metaplasia in Barrett＇s esophagus（BE）. Methods 29 endoscopic BE patients diagnosed from April to November in 2006 were enrolled. Common endoscopy followed by narrow band imaging（NBI）, then chromoendoscopy （indigo carmine） combined magnifying endoscopy was sequentially used and the quality of images with different endoscopic methods was evaluated ; Five pit patterns were captured according Endo type. The operative endoscopist observed the BE pit pattern by NBI and biopsy in suspicious area to identify special intestine metaplasia. Results Visualization of squamo-columnar epithelium by NBI is the clearest, followed by chromoendoscopy and common endoscopy. In contrast to common edoscopy, the observation of both pit pattern and epithelium capillary by NBI is much clearer. The accuracy of specialized intestinal metaplasia（SIM） on target biopsies according to Endo type（ 1V and V pit pattern are suspected of having SIM epithelium） was 93%, the sensitivity and specificity were 89% and 95%, respectively. Conclusion As a novel endoscopic system, NBI is very easy to operate, and it can not only capture the optimal images of Barrett＇s epithelium, but also show the pit pattern and capillary.
出处
《中华消化内镜杂志》
2007年第1期14-18,共5页
Chinese Journal of Digestive Endoscopy
