Kiesslich Ralf, Goetz Martin, Burg Juergen, Stolte Manfred, Siegel Ekkehard, Maeurer Markus J, Thomas Steven, Strand Dennis, Galle Peter R, Neurath Markus F
I. Medical Clinic, Johannes Gutenberg University of Mainz, Germany.
Gastroenterology. 2005 Jun;128(7):2119-23. doi: 10.1053/j.gastro.2004.12.035.
BACKGROUND & AIMS: Confocal laser endomicroscopy enables subsurface microscopic imaging of living tissue during ongoing endoscopy. This case report describes the in vivo detection of Helicobacter pylori by endomicroscopy.
Endomicroscopy (Pentax, Tokyo, EC-3870CIFK) was performed by using two different contrast stains: Topical Acriflavine in addition to intravenously applied fluorescein netted the surface and allowed identification of focal accumulation of Helicobacter pylori at the surface and in deeper layer of the gastric epithelium. Biopsies were performed at the antrum and corpus for urease testing and histology. In addition, biopsies were cultured for Helicobacter pylori. Cultured bacteria were re-assessed ex vivo using confocal microscopy with and without acriflavine staining.
Helicobacter pylori infection could be detected in a 70-year-old male by endomicroscopy. Accumulated, as well as single bacteria, could be observed and the distinct shape and flagella of Helicobacter pylori could be identified. Helicobacter pylori infection was proved by histology. Furthermore, ex vivo examination of cultures proved the presence of Helicobacter pylori and the active uptake of acriflavine into the bacteria.
Endomicroscopy is a new diagnostic approach, which enables the immediate diagnosis of Helicobacter pylori in vivo during standard video endoscopy.
共聚焦激光内镜检查可在内镜检查过程中对活体组织进行亚表面显微成像。本病例报告描述了通过内镜检查对幽门螺杆菌进行体内检测的情况。
使用两种不同的对比染色剂进行内镜检查（宾得，东京，EC - 3870CIFK）：除静脉注射荧光素外，局部应用吖啶黄可使表面显影，并有助于识别胃上皮表面和深层幽门螺杆菌的局灶性聚集。在胃窦和胃体取活检进行尿素酶检测和组织学检查。此外，对活检组织进行幽门螺杆菌培养。对培养的细菌在体外使用共聚焦显微镜进行重新评估，有或没有吖啶黄染色。
通过内镜检查在一名70岁男性中检测到幽门螺杆菌感染。可以观察到聚集的以及单个的细菌，并且可以识别幽门螺杆菌独特的形状和鞭毛。组织学检查证实了幽门螺杆菌感染。此外，对培养物的体外检查证实了幽门螺杆菌的存在以及吖啶黄被细菌主动摄取。
内镜检查是一种新的诊断方法，能够在标准视频内镜检查期间对幽门螺杆菌进行体内即时诊断。
