Amano Yuji
Division of Gastrointestinal Endoscopy, Shimane University Hospital.
Nihon Rinsho. 2005 Aug;63(8):1416-9.
Some kinds of chromoendoscopy have been reported to survey the cases with Barrett's esophagus more effectively, since random biopsy as a gold standard is not an ideal method from the viewpoint of safety, labor or cost effectiveness. Methylene blue (MB) chromoendoscopy has been reported that a targeted biopsy is possible to limit because MB only stains non-dysplastic Barrett's mucosa but not dysplastic one. However, many of supplementary studies have not agreed this recommendation. Crystal violet (CV) chromoendoscopy clearly stains Barrett's mucosa and makes a detailed observation of pit pattern possible. The availability of this method is required a further mass survey although CV chromoendoscopy has been reported to be effective in Barrett's screening. Other chromoendoscopic methods using indigo carmine or fluorescence dye also have been reported to be effective for discovering a dysplastic lesion by some investigator, but the efficacy has not been sufficiently evidenced. Conclusively, chromoendoscopic diagnosis of Barrett's esophagus has not yet got a consensus in the availability for Barrett's surveillance at present in Barrett's Esophagus Chicago Workshop 2003 of AGA.
据报道，某些类型的色素内镜检查能更有效地筛查巴雷特食管病例，因为作为金标准的随机活检从安全性、工作量或成本效益的角度来看并非理想方法。据报道，亚甲蓝（MB）色素内镜检查能够进行靶向活检，因为MB仅对无异型增生的巴雷特黏膜染色，而异型增生的黏膜则不会被染色。然而，许多补充研究并不认同这一观点。结晶紫（CV）色素内镜检查能清晰地对巴雷特黏膜进行染色，从而详细观察其凹陷形态。尽管据报道CV色素内镜检查在巴雷特食管筛查中有效，但该方法的实用性仍需进一步大规模研究。一些研究者还报告称，使用靛胭脂或荧光染料的其他色素内镜检查方法在发现异型增生病变方面也有效，但其有效性尚未得到充分证实。总之，在2003年美国胃肠病学会芝加哥巴雷特食管研讨会上，色素内镜检查在巴雷特食管监测中的实用性目前尚未达成共识。
