使用 SAFE-3000 的自体荧光视频内镜系统评估胃浅表性肿瘤。

Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan.

J Gastroenterol Hepatol. 2010 Apr;25(4):706-11. doi: 10.1111/j.1440-1746.2009.06202.x.

BACKGROUND

Autofluorescence (AF) videoendoscopy has an advantage over ordinary videoendoscopy in the diagnosis of gastric neoplasias, and the aim of the present study was to evaluate the effectiveness of using the SAFE-3000 videoendoscopy system to diagnose superficial gastric neoplasias.

METHODS

Ordinary videoendoscopy, AF videoendoscopy, and chromoendoscopy (CE) were used to diagnose the tumor existence and extent in 14 patients with gastric adenoma, 40 patients with intestinal-type early gastric cancer (EGC) (10 protruded, and 30 depressed), and nine patients with diffuse-type EGC. The diagnostic accuracies of the three kinds of images were evaluated by comparison with the results of histopathological assessment of resected specimens.

RESULTS

For gastric adenomas the diagnostic accuracy between the AF images and white light (WL) images did not differ significantly, and for protruded intestinal-type EGCs and diffuse-type EGCs the diagnostic accuracy did not differ significantly between any of the types of images. For depressed intestinal-type EGCs, the diagnostic accuracy of AF images tended to be higher than that of the WL images (P < 0.05) and it was not significantly different from that of the CE images. The detection rate of pink or orange color in AF images was significantly higher for protruded intestinal-type EGCs than gastric adenomas (P = 0.005), depressed intestinal-type EGCs (P < 0.001), and diffuse-type EGCs (P = 0.027).

CONCLUSIONS

Autofluorescence videoendoscopy using the SAFE-3000 system for gastric neoplasias might be useful for diagnosing depressed intestinal-type early gastric cancers. The detection of orange or pink color in AF images may be efficacious in discriminating protruded intestinal-type early gastric cancers from gastric adenomas.

背景

荧光内镜在胃肿瘤诊断方面优于普通内镜，本研究旨在评估 SAFE-3000 视频内镜系统诊断胃黏膜浅表性肿瘤的有效性。

方法

对 14 例胃腺瘤、40 例肠型早期胃癌（EGC）（10 例隆起型，30 例凹陷型）和 9 例弥漫型 EGC 患者，采用普通内镜、荧光内镜和染色内镜（CE）诊断肿瘤的存在和范围。通过与切除标本的组织病理学评估结果比较，评估三种图像的诊断准确性。

结果

胃腺瘤的荧光图像与白光图像的诊断准确性无显著差异，隆起型肠型 EGC 和弥漫型 EGC 的图像类型之间的诊断准确性无显著差异。对于凹陷型肠型 EGC，荧光图像的诊断准确性倾向于高于白光图像（P < 0.05），与 CE 图像无显著差异。荧光图像中粉红色或橙色的检出率在隆起型肠型 EGC 中明显高于胃腺瘤（P = 0.005）、凹陷型肠型 EGC（P < 0.001）和弥漫型 EGC（P = 0.027）。