Kara Mohammed A, Peters Femke P, Ten Kate Fiebo J W, Van Deventer Sander J, Fockens Paul, Bergman Jacques J G H M
Department of Gastroenterology and Hepatology, Academic Medical Center, Amsterdam, the Netherlands.
Gastrointest Endosc. 2005 May;61(6):679-85. doi: 10.1016/s0016-5107(04)02577-5.
The aim of this study was to investigate the feasibility of detecting high-grade dysplasia (HGD) and early cancer (EC) in Barrett's esophagus (BE) with a prototype video autofluorescence endoscope.
Sixty patients with BE were evaluated with a prototype, high-resolution videoendoscope that has separate charge-coupled devices for white light endoscopy (WLE) and autofluorescence imaging (AFI). Nondysplastic BE appears green on AFI, whereas potentially neoplastic areas appear blue/violet. The BE was first screened with WLE for visible abnormalities and then was examined by AFI to detect additional lesions. Lesions that raised a suspicion of neoplasia and control areas that were normal on AFI were sampled for histopathologic assessment. Finally, random 4-quadrant biopsy specimens were obtained at 2-cm intervals.
A diagnosis of HGD/EC was made in 22 patients; one patient had no visible abnormality, and 21 had endoscopically detectable areas with HGD/EC. In 6 of the latter 21 patients, the HGD/EC was detected with AFI alone; in another patient, HGD/EC was detected with AFI and random biopsies. In 14 patients, HGD/EC was detected with both WLE and AFI; in 3 of these 14 patients, additional lesions containing HGD/EC were detected by AFI alone.
The results of this study suggest that video AFI may improve the detection of HGD/EC in patients with BE.
本研究旨在探讨使用原型视频自体荧光内窥镜检测巴雷特食管（BE）中的高级别异型增生（HGD）和早期癌症（EC）的可行性。
60例BE患者使用一种原型高分辨率视频内窥镜进行评估，该内窥镜具有用于白光内镜检查（WLE）和自体荧光成像（AFI）的独立电荷耦合器件。非异型增生性BE在AFI上显示为绿色，而潜在的肿瘤区域显示为蓝色/紫色。首先用WLE对BE进行筛查以发现可见异常，然后通过AFI检查以检测其他病变。对怀疑有肿瘤形成的病变和AFI上正常的对照区域进行组织病理学评估取样。最后，每隔2 cm获取随机的四象限活检标本。
22例患者被诊断为HGD/EC；1例患者无可见异常，21例患者在内窥镜下可检测到HGD/EC区域。在这21例患者中的6例中，仅通过AFI检测到HGD/EC；在另一例患者中，通过AFI和随机活检检测到HGD/EC。在14例患者中，通过WLE和AFI均检测到HGD/EC；在这14例患者中的3例中，仅通过AFI检测到含有HGD/EC的其他病变。
本研究结果表明，视频AFI可能会提高BE患者中HGD/EC的检测率。
