Chair and Clinical Department of Internal Diseases, Angiology and Physical Medicine, Centre for Laser Diagnostics and Therapy, Silesian Medical University, Bytom, Poland.
Photodiagnosis Photodyn Ther. 2012 Mar;9(1):5-10. doi: 10.1016/j.pdpdt.2011.11.005. Epub 2011 Dec 23.
Oesophageal papilloma and Barrett's oesophagus are benign lesions known as risk factors of carcinoma in the oesophagus. Therefore, it is important to diagnose these early changes before neoplastic transformation.
Autofluorescence endoscopy is a fast and non-invasive method of imaging of tissues based on the natural fluorescence of endogenous fluorophores. The aim of this study was to prove the diagnostic utility of autofluorescence endoscopy with digital image processing in histological diagnosis of endoscopic findings in the upper digestive tract, primarily in the imaging of oesophageal papilloma.
During the retrospective analysis of about 200 endoscopic procedures in the upper digestive tract, 67 cases of benign, precancerous or cancerous changes were found. White light endoscopy (WLE) image, single-channel (red or green) autofluorescence images, as well as green and red fluorescence intensities in two modal fluorescence image and red-to-green (R/G) ratio (Numerical Colour Value, NCV) were correlated with histopathologic results. The NCV analysis in autofluorescence imaging (AFI) showed increased R/G ratio in cancerous changes in 96% vs. 85% in WLE. Simultaneous analysis with digital image processing allowed us to diagnose suspicious tissue as cancerous in all of cases. Barrett's metaplasia was confirmed in 90% vs. 79% (AFI vs. WLE), and 98% in imaging with digital image processing. In benign lesions, WLE allowed us to exclude tissue as malignant in 85%. Using autofluorescence endoscopy R/G ratio was increased in only 10% of benign changes causing the picture to be interpreted as suspicious, but when both methods were used together, 97.5% were cases excluded as malignancies. Mean R/G ratios were estimated to be 2.5 in cancers, 1.25 in Barrett's metaplasia and 0.75 in benign changes and were statistically significant (p=0.04).
Autofluorescence imaging is a sensitive method to diagnose precancerous and cancerous early stages of the diseases located in oesophagus. Especially in two-modal imaging including white light endoscopy, autofluorescence imaging with digital image processing seems to be a useful modality of early diagnostics. Also in observation of papilloma changes, it facilitates differentiation between neoplastic and benign lesions and more accurate estimation of the risk of potential malignancy.
食管乳头状瘤和巴雷特食管是良性病变，被认为是食管癌的危险因素。因此，在发生肿瘤性转化之前，早期诊断这些变化非常重要。
自发荧光内镜检查是一种快速、非侵入性的组织成像方法，基于内源性荧光团的自然荧光。本研究旨在通过数字图像处理证明自发荧光内镜检查在诊断上的效用，主要是在食管乳头状瘤的内镜检查结果成像中。
在对上消化道约 200 例内镜检查的回顾性分析中，发现 67 例良性、癌前或癌性病变。白光内镜（WLE）图像、单通道（红色或绿色）自发荧光图像以及双模态荧光图像中的绿光和红光强度以及红/绿（数值颜色值，NCV）比值与组织病理学结果相关。在自发荧光成像（AFI）中，NCV 分析显示癌性病变的 R/G 比值增加了 96%，而 WLE 为 85%。同时进行数字图像处理分析，能够诊断出所有疑似组织为癌性。巴雷特化生的确诊率为 90%（AFI 为 90%，WLE 为 79%），而数字图像处理的成像率为 98%。在良性病变中，WLE 能够排除 85%的恶性组织。仅使用自发荧光内镜检查，R/G 比值增加仅见于 10%的良性病变，使图像被解读为可疑，但当两种方法同时使用时，97.5%的恶性病变被排除。估计癌症的平均 R/G 比值为 2.5，巴雷特化生为 1.25，良性病变为 0.75，差异有统计学意义（p=0.04）。
自发荧光成像是一种敏感的方法，可用于诊断位于食管的癌前和癌性早期阶段。特别是在包括白光内镜检查在内的双模态成像中，数字图像处理的自发荧光成像似乎是一种有用的早期诊断方法。在观察乳头状瘤变化时，它有助于区分肿瘤性和良性病变，并更准确地估计潜在恶性的风险。
