CAJ | 학술논문

目的应用色彩增强技术(FICE)联合内镜观察食管病变后食管上皮乳头内毛细血管袢(IPCL)的改变,探讨FICE在食管病变诊断中的价值.方法对患者先行普通胃镜检查,发现食管病变后再利用富士能EG-590ZW内镜行FICE观察,分析食管病变后食管上皮IPCL改变,并研究了31例浅表性食管病变的IPCL与病理组织学之间关系.结果 (1)FICE放大观察将IPCL分为4型:Ⅰ型IPCL分布均匀,形态规则,见于正常食管;Ⅱ型IPCL延长,主要见于食管炎;Ⅲ型IPCL出现扩张、波浪样弯曲、管径粗细不均以及不规则形态改变中的2至3种改变,主要见于食管上皮异型增生;Ⅳ型IPCL出现扩张、波浪样弯曲、管径粗细不均以及不规则形态改变中所有4种变化,主要见于食管鳞癌.(2)17例食管炎中15例IPCL表现为Ⅱ型、2例表现为Ⅲ型;10例食管上皮异型增生中8例IPCI表现为Ⅲ型、2例表现为Ⅳ型,表现为Ⅳ型的2例均为重度食管上皮异型增生;1例sml食管鳞癌IPCL表现为Ⅲ型;3例进展期食管鳞癌均表现为Ⅳ型.结论 FICE联合内镜能清楚显示食管黏膜IPCL,通过应用FICE联合内镜观察食管病灶的IPCL变化,可以很好地确定食管浅表性病变的性质,对食管肿瘤性病变的诊断具有重要的应用价值.
목적 응용색채증강기술(FICE)연합내경관찰식관병변후식관상피유두내모세혈관번(IPCL)적개변,탐토FICE재식관병변진단중적개치.방법 대환자선행보통위경검사,발현식관병변후재이용부사능EG-590ZW내경행FICE관찰,분석식관병변후식관상피IPCL개변,병연구료31례천표성식관병변적IPCL여병리조직학지간관계.결과 (1)FICE방대관찰장IPCL분위4형:Ⅰ형IPCL분포균균,형태규칙,견우정상식관;Ⅱ형IPCL연장,주요견우식관염;Ⅲ형IPCL출현확장、파랑양만곡、관경조세불균이급불규칙형태개변중적2지3충개변,주요견우식관상피이형증생;Ⅳ형IPCL출현확장、파랑양만곡、관경조세불균이급불규칙형태개변중소유4충변화,주요견우식관린암.(2)17례식관염중15례IPCL표현위Ⅱ형、2례표현위Ⅲ형;10례식관상피이형증생중8례IPCI표현위Ⅲ형、2례표현위Ⅳ형,표현위Ⅳ형적2례균위중도식관상피이형증생;1례sml식관린암IPCL표현위Ⅲ형;3례진전기식관린암균표현위Ⅳ형.결론 FICE연합내경능청초현시식관점막IPCL,통과응용FICE연합내경관찰식관병조적IPCL변화,가이흔호지학정식관천표성병변적성질,대식관종류성병변적진단구유중요적응용개치.
Objective To assess the potential diagnostic value of the potential of flexible image col-or enhancement system(FICE)with magnifying endoscopy for superficial esophageal lesions by observing the intrapapillary capillary loops(IPCL)in esophageal mucosa. Methods IPCL in patients with esophageal diseases were studied with Fujinon EG-590ZW FICE endoscopy. The relationship between changes of IPCL in 31 cases of superficial esophageal lesions and pathological findings was studied. Results The vascular patterns of IPCL were analyzed and classified as follows: Type Ⅰ,often seen in normal esophagus,were e- venly distributed with regular forms. TypeⅡ,protracted,often occured in esophagitis. Type Ⅲ showed two or three of such four changes as,dilatation,wave-like inflection,irregular caliber and deformity,which was mainly seen in dysplasia. While Type Ⅳshowed all the four changes mentioned above and frequently ap- peared in esophageal cancer. Of the 17 cases of esophagitis,fifteen cases were TypeⅡIPCL and the others Type Ⅲ. Of the 10 cases of dysplasia,eight were Type Ⅲ IPCL and two high-grade dysplasia showed Type Ⅳ IPCL. One sml early esophageal cancer showed Type Ⅲ IPCL and all three advanced esophageal cancer showed TypeⅣ IPCL. Conclusion The esophageal microvessels can be clearly seen by FICE with magnif- ying endoscopy,and the differentiation of superficial esophageal lesions can be fairly performed with the ob- servation of IPCL,it gives an important practical siginificance in diagnosing tumorous lesions.