Yagi Kazuyoshi, Nakamura Atsuo, Sekine Atsuo
Internal Medicine, Niigata Prefectural Yoshida Hospital.
Nihon Rinsho. 2005 Aug;63(8):1411-5.
Intestinal metaplasia of Barrett's esophagus is pre-cancerous lesion and it is important to diagnose intestinal metaplasia by endoscopic examination. Predefined 4 quadrant sampling technique is popular in western countries. However, chromoendoscopy or magnification endoscopy have been tried to diagnose intestinal metaplasia. We have carried out magnification endoscopy with methylene blue and magnification endoscopy with acetic acid. In magnification endoscopy with methylene blue, intestinal metaplasia showed blue-staining area with tubulaous or cavernous pattern. In magnification endoscopy with acetic acid, all of epithelium of Barrett's esophagus changed to whitening surface and it was easy to observe the structure of each epithelium. Intestinal metaplasia showed tubulaous or villous, although fundic type showed pits of small round and cardiac type showed oval pattern with central-slit pits.
巴雷特食管的肠化生是一种癌前病变，通过内镜检查诊断肠化生很重要。预定义的四象限采样技术在西方国家很流行。然而，已经尝试使用染色内镜或放大内镜来诊断肠化生。我们进行了亚甲蓝放大内镜检查和醋酸放大内镜检查。在亚甲蓝放大内镜检查中，肠化生表现为蓝色染色区域，呈管状或海绵状形态。在醋酸放大内镜检查中，巴雷特食管的所有上皮均变为白色表面，便于观察各上皮的结构。肠化生表现为管状或绒毛状，而胃底型表现为小圆形凹坑，贲门型表现为带有中央裂隙凹坑的椭圆形形态。
