Li Yan Xia, Shen Lei, Yu Hong Gang, Luo He Sheng, Yu Jie Ping
Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China.
Turk J Gastroenterol. 2014 Aug;25(4):365-9. doi: 10.5152/tjg.2014.6190.
BACKGROUND/AIMS: Esophageal squamous cell carcinoma is a common malignant tumor in recent years, and the key for improving the survival rate is early diagnosis and treatment. Computed virtual chromoendoscopy with the Fujinon intelligent color enhancement (FICE) system was reported to improve visualization of neoplastic and non-neoplastic lesions in gastroscopy and colonoscopy. The purpose of this study was to evaluate the value of FICE in the diagnosis of early esophageal squamous cell carcinoma and precancerous lesions.
Two hundred fifty-seven patients with suspicious lesions of the esophagus were examined successively by FICE, magnifying FICE, Lugol chromoendoscopy, and magnifying Lugol chromoendoscopy in the hospital. The lesions and the intrapapillary capillary loop (IPCL, microvessels at the surface of esophageal carcinoma) were observed and compared with the pathologic diagnosis that was regarded as the golden standard.
The positive rates of early esophageal squamous cell carcinoma were 92.6% and 88.9% as examined by FICE and Lugol chromoendoscopy (p>0.05), and 96.3% and 92.6% as examined by magnifying FICE and magnifying Lugol chromoendoscopy (p>0.05), respectively. The magnifying FICE could observe the IPCL of the esophagus clearly. Early esophageal squamous cell carcinoma and high-grade intraepithelial neoplasia were mainly type IV and type V. Low-grade intraepithelial neoplasia and esophagitis were type II and type III, and normal esophagus was type I; however, the observation of the IPCL by magnifying Lugol chromoendoscopy was not clear.
Fujinon intelligent color enhancement and magnifying FICE are complements to Lugol chromoendoscopy and magnifying Lugol chromoendoscopy in the diagnosis of early esophageal lesions.
背景/目的：食管鳞状细胞癌是近年来常见的恶性肿瘤，提高生存率的关键在于早期诊断和治疗。据报道，采用富士能智能色彩增强（FICE）系统的计算机虚拟染色内镜可改善胃镜和结肠镜检查中肿瘤性和非肿瘤性病变的可视化。本研究旨在评估FICE在早期食管鳞状细胞癌及癌前病变诊断中的价值。
对257例食管可疑病变患者在我院依次进行FICE、放大FICE、卢戈氏染色内镜及放大卢戈氏染色内镜检查。观察病变及乳头内毛细血管袢（IPCL，食管癌表面的微血管），并与被视为金标准的病理诊断结果进行比较。
FICE和卢戈氏染色内镜检查早期食管鳞状细胞癌的阳性率分别为92.6%和88.9%（p>0.05），放大FICE和放大卢戈氏染色内镜检查的阳性率分别为96.3%和92.6%（p>0.05）。放大FICE能清晰观察食管的IPCL。早期食管鳞状细胞癌和高级别上皮内瘤变主要为IV型和V型。低级别上皮内瘤变和食管炎为II型和III型，正常食管为I型；然而，放大卢戈氏染色内镜对IPCL的观察不清晰。
在早期食管病变的诊断中，富士能智能色彩增强及放大FICE是对卢戈氏染色内镜及放大卢戈氏染色内镜的补充。
