在巴雷特食管患者中使用大型活检钳提高标本充足率。

Improved specimen adequacy using jumbo biopsy forceps in patients with Barrett's esophagus.

作者信息

Martinek Jan, Maluskova Jana, Stefanova Magdalena, Tuckova Inna, Suchanek Stepan, Vackova Zuzana, Krajciova Jana, Kollar Marek, Zavoral Miroslav, Spicak Julius

机构信息

Jan Martinek, Zuzana Vackova, Jana Krajciova, Julius Spicak, Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, 14021 Prague, Czech Republic.

出版信息

World J Gastroenterol. 2015 May 7;21(17):5328-35. doi: 10.3748/wjg.v21.i17.5328.

DOI:10.3748/wjg.v21.i17.5328

PMID:25954107

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4419074/

Abstract

AIM

To assess the sampling quality of four different forceps (three large capacity and one jumbo) in patients with Barrett's esophagus.

METHODS

This was a prospective, single-blind study. A total of 37 patients with Barrett's esophagus were enrolled. Targeted or random biopsies with all four forceps were obtained from each patient using a diagnostic endoscope during a single endoscopy. The following forceps were tested: A: FB-220K disposable large capacity; B: BI01-D3-23 reusable large capacity; C: GBF-02-23-180 disposable large capacity; and jumbo: disposable Radial Jaw 4 jumbo. The primary outcome measurement was specimen adequacy, defined as a well-oriented biopsy sample 2 mm or greater with the presence of muscularis mucosa.

RESULTS

A total of 436 biopsy samples were analyzed. We found a significantly higher proportion of adequate biopsy samples with jumbo forceps (71%) (P < 0.001 vs forceps A: 26%, forceps B: 17%, and forceps C: 18%). Biopsies with jumbo forceps had the largest diameter (median 2.4 mm) (P < 0.001 vs forceps A: 2 mm, forceps B: 1.6 mm, and forceps C: 2mm). There was a trend for higher diagnostic yield per biopsy with jumbo forceps (forceps A: 0.20, forceps B: 0.22, forceps C: 0.27, and jumbo: 0.28). No complications related to specimen sampling were observed with any of the four tested forceps.

CONCLUSION

Jumbo biopsy forceps, when used with a diagnostic endoscope, provide more adequate specimens as compared to large-capacity forceps in patients with Barrett's esophagus.

摘要

目的

评估四种不同活检钳（三把大容量活检钳和一把超大号活检钳）在巴雷特食管患者中的取材质量。

方法

这是一项前瞻性单盲研究。共纳入37例巴雷特食管患者。在一次内镜检查中，使用诊断性内镜通过所有四种活检钳对每位患者进行靶向或随机活检。测试的活检钳如下：A：FB - 220K一次性大容量活检钳；B：BI01 - D3 - 23可重复使用大容量活检钳；C：GBF - 02 - 23 - 180一次性大容量活检钳；超大号：一次性径向 Jaw 4超大号活检钳。主要观察指标为标本充足性，定义为具有黏膜肌层的、方向良好的2毫米或更大的活检样本。

结果

共分析了436份活检样本。我们发现超大号活检钳获取的充足活检样本比例显著更高（71%）（与活检钳A：26%、活检钳B：17%和活检钳C：18%相比，P < 0.001）。超大号活检钳获取的活检样本直径最大（中位数2.4毫米）（与活检钳A：2毫米、活检钳B：1.6毫米和活检钳C：2毫米相比，P < 0.001）。超大号活检钳每次活检的诊断率有更高的趋势（活检钳A：0.20，活检钳B：0.22，活检钳C：0.27，超大号：0.28）。四种测试活检钳均未观察到与标本取材相关的并发症。