Arul P, Vinoth B, Alexander Thomas, Phansalkar Manjiri, Padhi Somanath
Department of Pathology, Dhanalakshmi Srinivasan Medical College and Hospital, Siruvachur, Perambalur, Tamil Nadu, India.
Saudi J Gastroenterol. 2015 Sep-Oct;21(5):330-6. doi: 10.4103/1319-3767.164205.
Background /Aim: Narrow band imaging (NBI) is a novel, innovative high-resolution endoscopic technique, which utilizes spectral narrow band filter for the visualization of mucosal patterns and microvasculature. Nonerosive reflux disease (NERD) is a type of gastroesophageal reflux disease (GERD) and it is characterized by reflux symptoms without mucosal breaks on white light endoscopy (WLE). Biopsies from distal esophagus of GERD patients show group of histologic features such as basal cell hyperplasia, elongation of lamina propria papillae, and inflammatory cells. The present study was undertaken to evaluate diagnostic utility of NBI endoscopy and biopsy study in NERD patients and also to correlate NBI endoscopy findings with histologic features of GERD.
A total of 71 cases of NERD having symptom score more than 10 and those not having erosion on WLE were recruited prospectively and underwent NBI endoscopic examination. Two mucosal biopsies were taken at 3 cm above the squamocolumnar junction.
Histologic features of GERD were seen in 50 (70.4%) out of 71 cases. No significant correlation between NBI endoscopic findings with histologic features of GERD was found.
The present study showed that histopathologic evaluation of distal esophageal mucosa has promising diagnostic value over NBI endoscopy in NERD patients. Use of newly introduced NBI technique requires tremendous familiarity for the detection of the cases of NERD, which show histologic features of GERD.
背景/目的:窄带成像(NBI)是一种新型的、创新性的高分辨率内镜技术,它利用光谱窄带滤光片来观察黏膜形态和微血管。非糜烂性反流病(NERD)是胃食管反流病(GERD)的一种类型,其特征是在白光内镜检查(WLE)时出现反流症状但无黏膜破损。GERD患者远端食管活检显示出一组组织学特征,如基底细胞增生、固有层乳头延长和炎症细胞。本研究旨在评估NBI内镜检查和活检研究在NERD患者中的诊断效用,并将NBI内镜检查结果与GERD的组织学特征进行关联。
前瞻性招募了71例症状评分超过10且在WLE时无糜烂的NERD患者,并对其进行了NBI内镜检查。在鳞柱状交界处上方3 cm处取两块黏膜活检组织。
71例患者中有50例(70.4%)出现了GERD的组织学特征。未发现NBI内镜检查结果与GERD组织学特征之间存在显著相关性。
本研究表明,在NERD患者中,远端食管黏膜的组织病理学评估比NBI内镜检查具有更有前景的诊断价值。对于检测显示出GERD组织学特征的NERD病例,使用新引入的NBI技术需要极高的熟练度。