Anagnostopoulos G K, Yao K, Kaye P, Hawkey C J, Ragunath K
Wolfson Digestive Diseases Centre, Queen's Medical Centre, University Hospital, Nottingham, UK.
Aliment Pharmacol Ther. 2007 Aug 1;26(3):501-7. doi: 10.1111/j.1365-2036.2007.03374.x.
High resolution magnification endoscopy with narrow band imaging (NBI) may improve the detection of specialised intestinal metaplasia (SIM) and dysplasia in Barrett's oesophagus.
To describe the magnified endoscopic features with the use of NBI in Barrett's oesophagus.
Three hundred and forty-four areas from 50 patients with Barrett's oesophagus were studied using high resolution magnification endoscopy (HRME) with NBI and targeted biopsies were obtained. The sensitivity, specificity, predictive values of the various patterns for the prediction of SIM and dysplasia were calculated.
The magnified endoscopic features of Barrett's oesophagus with the use of NBI consist of microstructural/microvascular patterns. The yield of SIM according to the patterns was: (i) Regular microstructural pattern with tubular/linear/villous pattern 90.6% and with circular pattern 0%; and (ii) Absent microstructural pattern 98.9%. The sensitivity, specificity, positive and negative predictive values of the combination of regular microstructural pattern (tubular/villous/linear) and absent microstructural pattern to detect SIM were 100%, 78.8%, 93.5% and 100%, respectively. The sensitivity, specificity, positive and negative predictive values of the irregular microvascular/microstructural pattern for the prediction of high grade dysplasia were 90%, 100%, 99.2% and 100%, respectively.
High resolution magnification endoscopy with NBI allows clear visualisation of microstructural and microvascular patterns within Barrett's oesophagus, and allows targeted biopsy with a high yield of SIM and high grade dysplasia.
窄带成像（NBI）高分辨率放大内镜检查可能会提高巴雷特食管中特殊肠化生（SIM）和发育异常的检测率。
描述在巴雷特食管中使用NBI的放大内镜特征。
使用NBI高分辨率放大内镜检查（HRME）对50例巴雷特食管患者的344个区域进行研究，并进行靶向活检。计算各种模式对SIM和发育异常预测的敏感性、特异性和预测值。
使用NBI的巴雷特食管放大内镜特征包括微观结构/微血管模式。根据这些模式，SIM的检出率为：（i）具有管状/线性/绒毛状模式的规则微观结构模式为90.6%，具有圆形模式的为0%；（ii）无微观结构模式为98.9%。规则微观结构模式（管状/绒毛状/线性）和无微观结构模式联合检测SIM的敏感性、特异性、阳性和阴性预测值分别为100%、78.8%、93.5%和100%。不规则微血管/微观结构模式预测高级别发育异常的敏感性、特异性、阳性和阴性预测值分别为90%、100%、99.2%和100%。
NBI高分辨率放大内镜检查能够清晰显示巴雷特食管内的微观结构和微血管模式，并能进行靶向活检，对SIM和高级别发育异常的检出率很高。
