Department of Medicine, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
Gut Liver. 2008 Dec;2(3):174-9. doi: 10.5009/gnl.2008.2.3.174. Epub 2008 Dec 31.
BACKGROUND/AIMS: The aim of this study was to determine whether the margin of early to be detected gastric cancer (EGC) and gastric adenoma is easier to be detected with autofluorescence imaging (AFI) than with white-light endoscopy (WLE).
A total of 102 lesions (48 EGCs and 54 gastric adenomas) found in 98 patients were removed endoscopically or surgically. The measured length of each pathology specimen was compared with the lengths estimated using WLE, AFI, and chromoendoscopy.
The lesions could be discriminated from surrounding mucosa by AFI in 86 cases (84.3%). The detection rates were similar for elevated lesions (85.1%) and flat/depressed lesions (82.9%, p=0.770). In terms of histology, the detection rate was slightly higher for adenomas (90.7%) than for cancer (77.1%, p=0.058). The estimated length was shorter than the pathologic length in 31.4% of cases when using WLE and 22.1% of cases when using AFI (p=0.168). The resection range was larger for EMR than for AFI in 24 of 80 cases (30.0%).
WLE tends to underestimate the size of EGCs, whereas AFI tends to overestimate their size.
背景/目的:本研究旨在确定早期胃癌(EGC)和胃腺瘤的边界是否更容易通过自发荧光成像(AFI)检测,而不是通过白光内镜(WLE)检测。
对 98 例患者的 102 处病变(48 例 EGC 和 54 例胃腺瘤)进行内镜或手术切除。将每个病理标本的测量长度与使用 WLE、AFI 和 chromoendoscopy 估计的长度进行比较。
在 86 例(84.3%)病例中,AFI 可将病变与周围黏膜区分开来。隆起性病变的检出率与平坦/凹陷性病变相似(85.1%和 82.9%,p=0.770)。就组织学而言,腺瘤的检出率略高于癌症(90.7%比 77.1%,p=0.058)。使用 WLE 时,估计长度比病理长度短的病例占 31.4%,使用 AFI 时占 22.1%(p=0.168)。在 80 例中有 24 例(30.0%)中,EMR 的切除范围大于 AFI。
WLE 往往低估 EGC 的大小,而 AFI 往往高估其大小。