Wellman Center for Photomedicine, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Gastrointest Endosc. 2010 Jan;71(1):35-43. doi: 10.1016/j.gie.2009.08.026. Epub 2009 Nov 17.
Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technique that has the potential to be used for acquiring comprehensive images of the entire distal esophagus endoscopically with subcellular resolution.
The goal of this study was to demonstrate large-area SECM in upper GI tissues and to determine whether the images contain microstructural information that is useful for pathologic diagnosis.
A feasibility study.
Gastrointestinal Unit, Massachusetts General Hospital.
Fifty biopsy samples from 36 patients undergoing routine EGD were imaged by SECM, in their entirety, immediately after their removal.
The microstructure seen in the SECM images was similar to that seen by histopathology. Gastric cardia mucosa was clearly differentiated from squamous mucosa. Gastric fundic/body type mucosa showed more tightly packed glands than gastric cardia mucosa. Fundic gland polyps showed cystically dilated glands lined with cuboidal epithelium. The presence of intraepithelial eosinophils was detected with the cells demonstrating a characteristic bilobed nucleus. Specialized intestinal metaplasia was identified by columnar epithelium and the presence of goblet cells. Barrett's esophagus (BE) with dysplasia was differentiated from specialized intestinal metaplasia by the loss of nuclear polarity and disorganized glandular architecture.
Ex vivo, descriptive study.
Large-area SECM images of gastroesophageal biopsy samples enabled the visualization of both subcellular and architectural features of various upper GI mucosal types and were similar to the corresponding histopathologic slides. These results suggest that the development of an endoscopic SECM probe is merited.
光谱编码共聚焦显微镜（SECM）是一种高速反射共聚焦显微镜技术，具有在整个远端食管内镜下以亚细胞分辨率获取全面图像的潜力。
本研究旨在演示上胃肠道组织的大面积 SECM，并确定这些图像是否包含有助于病理诊断的微观结构信息。
可行性研究。
马萨诸塞州总医院胃肠科。
36 例行常规 EGD 的患者的 50 个活检样本在取出后立即通过 SECM 进行整体成像。
SECM 图像中观察到的微观结构与组织病理学所见相似。胃贲门黏膜可与鳞状黏膜清楚区分。胃底/体型黏膜的腺体比胃贲门黏膜更紧密排列。胃底腺息肉显示囊性扩张的腺体，内衬立方上皮。通过细胞表现出特征性的双叶核，可以检测到上皮内嗜酸性粒细胞。柱状上皮和杯状细胞的存在可识别特殊的肠上皮化生。伴有异型增生的 Barrett 食管（BE）可通过核极性丧失和腺体结构紊乱与特殊的肠上皮化生区分开来。
离体、描述性研究。
胃食管活检样本的大面积 SECM 图像能够可视化各种上胃肠道黏膜类型的亚细胞和结构特征，与相应的组织病理学幻灯片相似。这些结果表明，值得开发一种内镜 SECM 探头。
