Pirogov S S, Sokolov V V, Kaprin A D, Volchenko N N, Karpova E S, Pavlov P V, Sukhin D G, Pogorelov N N, Ryabov A B, Khomyakov V M, Chulikov I A
Eksp Klin Gastroenterol. 2015(4):12-21.
Endocytoscopy is one of the most novel endoscopic diagnostic procedures, providing optical magnification up to 1150 times of gastrointestinal and respiratory tract mucosa. Such approach allows real-time tissue and cellular structure visualization. Endocytoscopy, along with confocal laser endomicroscopy, can be considered as "optical biopsy" in vivo. Of course, endocytoscopy currently is experimental diagnostic method, all available endocytoscopes are prototypes. According to published data, endocytoscopy can be used in precancerous conditions and early intramucosal cancer diagnostics in esophagus, stomach, colon and bronchial tree. Different types of endocytoscopes are used for examinations: some of them are baby-scopes, with fixed magnification 570-1150 times, introduced into accessory channel of the therapeutic parent-endoscope, others--are integrated type, providing scalable magnification from 80 to 380 times. As for traditional pathology ex vivo, for endocytoscopy mucosal cell nuclei stain is needed. For vital staining during endocytoscopy methylene blue, toluidine blue and crystal violet in different concentrations are more often used. In cases of squamous-cell dysplasia or cancer, it is recommended to use 1% methylene blue solution, whereas in intestinal type metaplasia, dysplastic changes and cancer (Barrett's esophagus, P. Correa precancerous cascade, colon adenomas), 1% toluidine blue is preferred. With endocytoscopy, after vital staining, we can visualize and estimate mucosa tissue and cell characteristics: papillae, crypt and gland shapes and sizes, their integrity (tissue markers); cell nuclei size and shape, polarity and nuclear dye intensity (cell markers).
内镜下细胞内镜检查是最新颖的内镜诊断方法之一，可对胃肠道和呼吸道黏膜进行高达1150倍的光学放大。这种方法能够实现实时的组织和细胞结构可视化。细胞内镜检查与共聚焦激光显微内镜检查一起，可被视为体内的“光学活检”。当然，目前细胞内镜检查仍是一种实验性诊断方法，所有可用的细胞内镜均为原型。根据已发表的数据，细胞内镜检查可用于食管、胃、结肠和支气管树的癌前病变及早期黏膜内癌的诊断。不同类型的细胞内镜用于检查：其中一些是微型内镜，固定放大倍数为570 - 1150倍，通过治疗性母内镜的附件通道插入；其他的是集成型，提供80至380倍的可缩放放大倍数。至于传统的离体病理学检查，细胞内镜检查需要对黏膜细胞核进行染色。在细胞内镜检查的活体染色过程中，更常使用不同浓度的亚甲蓝、甲苯胺蓝和结晶紫。对于鳞状细胞发育异常或癌症，建议使用1%的亚甲蓝溶液，而在肠化生、发育异常改变和癌症（巴雷特食管、P. 科雷亚癌前病变级联、结肠腺瘤）中，首选1%的甲苯胺蓝。通过细胞内镜检查，在活体染色后，我们可以观察并评估黏膜组织和细胞特征：乳头、隐窝和腺体的形状和大小、它们的完整性（组织标志物）；细胞核的大小和形状、极性以及核染色强度（细胞标志物）。
