Niepsuj Klaudia, Niepsuj Grzegorz, Cebula Wojciech, Zieleźnik Witold, Adamek Mariusz, Sielańczyk Andrzej, Adamczyk Jakub, Kurek Józef, Sieroń Aleksander
Centre for Laser Diagnostic and Therapy, Silesian Medical University, Bytom, Poland.
Gastrointest Endosc. 2003 Nov;58(5):715-9. doi: 10.1016/s0016-5107(03)02018-2.
The occurrence of precancerous lesions, such as high-grade dysplasia, in patients with short-segment Barrett's esophagus is controversial. This study assessed the efficacy of autofluorescence endoscopy for detection of high-grade dysplasia in short-segment Barrett's esophagus.
A total of 34 patients (28 men, 6 women; age range 40-77 years) with histopathologically proven short-segment Barrett's esophagus were studied. Autofluorescence endoscopy was performed by using monochromatized blue light (425-455 nm) filtered from a conventional xenon light source. A total of 136 and 109 biopsy specimens were taken from Barrett's mucosa under control, respectively, white light endoscopy and autofluorescence endoscopy.
High-grade dysplasia was found in 9 (8.3%) autofluorescence-guided biopsy specimens, which was significantly greater than the number of white light endoscopy-guided biopsy specimens with this finding (one positive biopsy specimen, 0.7% of total biopsy specimens obtained). Autofluorescence endoscopy detected high-grade dysplasia in 7 patients, 6 more than were identified with white light endoscopy. In the one patient with high-grade dysplasia detected by white light endoscopy-guided biopsy specimens, autofluorescence-guided biopsy specimens revealed only low-grade dysplasia.
Autofluorescence endoscopy in patients with short-segment Barrett's esophagus increases the detection rate of high-grade dysplasia.
短节段巴雷特食管患者中癌前病变（如高级别异型增生）的发生存在争议。本研究评估了自体荧光内镜检查在检测短节段巴雷特食管高级别异型增生中的有效性。
共研究了34例经组织病理学证实为短节段巴雷特食管的患者（28例男性，6例女性；年龄范围40 - 77岁）。使用从传统氙灯光源滤过的单色蓝光（425 - 455 nm）进行自体荧光内镜检查。分别在白光内镜检查和自体荧光内镜检查下，从巴雷特黏膜获取了总共136份和109份活检标本。
在9份（8.3%）自体荧光引导下的活检标本中发现了高级别异型增生，这显著多于白光内镜引导下活检标本中出现该情况的数量（1份阳性活检标本，占获取的活检标本总数的0.7%）。自体荧光内镜检查在7例患者中检测到高级别异型增生，比白光内镜检查多发现6例。在1例通过白光内镜引导下活检标本检测到高级别异型增生的患者中，自体荧光引导下的活检标本仅显示低级别异型增生。
短节段巴雷特食管患者使用自体荧光内镜检查可提高高级别异型增生的检出率。
