CAJ | 학술논문

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＞o.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.
목적 탐토수자염색내경(I-Scan)급공취초격광현미내경(CLE)대Barrett식관(BE)적진단개치.방법 878례환자행보통내경화I-Scan모식하검사,부분사사출적의사BE환자행CLE검사급활검,비교보통내경화I-Scan모식하의사BE검출솔급도상특점,대비분석활검병리급CLE진단BE결과.결과 보통위경모식하사사출의사BE환자46례(5.2％),I-Scan사사출52례(5.9％),량자비교차이무통계학의의(x2 =0.533,P＞o.05);보통위경모식하SCJ여CEJ간거간가관찰도책란상혈관자21례(45.7％),I-Scan가관찰도35례(67.3％),량자비교차이유통계학의의(x2 =0.031,P＜0.05).19례의사BE환자진행료CLE검사급활검,CLE진단BE적민감도、특이도분별위93％화100％.결론 I-Scan대SCJ여GEJ간거간책란상혈관적관찰구유중요의의,가제고의사BE검출솔;CLE사실시재체조직학진단성위가능,진단BE적민감도화특이도균교고.
Objective To evaluate digital chrome endoscopy (I-Scan) and confocal laser endomicroscopy (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 between pathology and CLE,were compared respectively.Results Suspected BE was diagnosed in 46 patients (5.2％) by routine endoscopy,and in52 (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.