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[共聚焦激光内镜显微镜在胃黏膜检查中的原理及操作流程]

[Confocal laser endomicroscopy principles and performing algorithm in gastric mucosa examination].

作者信息

Pirogov S S, Sokolov V V, Karpova E S, Pavlov P V, Volchenko N N, Kaprin A D

出版信息

Eksp Klin Gastroenterol. 2014(3):10-7.

Abstract

Accuracy of endoscopic examination in early gastric cancer and precancerous conditions diagnostics for many years depended only on quality of biopsy. That's why, risk of overlooking gastric focal carcinoma, particularly-- multiple, was relatively high. Last couple of years new endoscopic method--confocal laser endomicroscopy (CLE) was released for commercial use. This approach provides real-time information about morphology of gastric mucosa during endoscopic examination. CLE is a variation of confocal microscopy--morphologic technique, providing examination of thick specimens or live tissue. CLE system is a single-channel fluorescence microscope, used in endoscopy, where confocal probe incorporated into endoscope or mounted into accessory channel. For proper results of CLE intravenous administration of fluorescence agent is needed. In our study in P.A. Herzen Moscow Cancer Research Institute we have used 10% fluorescein sodium, due to acriflavine use is prohibited in Russian Federation. In 157 patients with suspected early gastric cancer mean time of CLE was 24 ± 3.5 min. In all cases descriptive images were acquired. Mean amount of endomicrosocpic images in one patient was as high as 162 ± 8.3.

摘要

多年来,早期胃癌及癌前病变诊断中内镜检查的准确性仅取决于活检质量。因此,漏诊胃局灶性癌,尤其是多发性癌的风险相对较高。过去几年,一种新的内镜检查方法——共聚焦激光显微内镜检查(CLE)已投入商业使用。这种方法在内镜检查过程中提供有关胃黏膜形态的实时信息。CLE是共聚焦显微镜检查——一种形态学技术的变体,用于检查厚标本或活组织。CLE系统是一种单通道荧光显微镜,用于内镜检查,其中共聚焦探头集成在内镜中或安装在附件通道中。为了获得CLE的正确结果,需要静脉注射荧光剂。在我们于莫斯科赫岑国立癌症研究中心进行的研究中,由于俄罗斯联邦禁止使用吖啶黄,我们使用了10%的荧光素钠。在157例疑似早期胃癌患者中,CLE的平均时间为24±3.5分钟。所有病例均采集了描述性图像。一名患者的内镜显微图像平均数量高达162±8.3。

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