Department of Mechanical Engineering, Lassonde School of Engineering, York University, Toronto, ON M3J 1P3, Canada.
Wellman Center for Photomedicine, Massachusetts General Hospital Harvard Medical School, Boston, MA, 02114, USA.
Sci Rep. 2018 Feb 8;8(1):2631. doi: 10.1038/s41598-018-20668-8.
Esophagogastroduodenoscopy (EGD) is a widely used procedure, posing significant financial burden on both healthcare systems and patients. Moreover, EGD is time consuming, sometimes difficult to tolerate, and suffers from an imperfect diagnostic yield as the limited number of collected biopsies does not represent the whole organ. In this paper, we report on technological and clinical feasibility of a swallowable tethered endomicroscopy capsule, which is administered without sedation, to image large regions of esophageal and gastric mucosa at the cellular level. To demonstrate imaging capabilities, we conducted a human pilot study (n = 17) on Eosinophilic Esophagitis (EoE) patients and healthy volunteers from which representative cases are presented and discussed. Results indicate that, compared to endoscopic biopsy, unsedated tethered capsule endomicroscopy obtains orders of magnitude more cellular information while successfully resolving characteristic tissue microscopic features such as stratified squamous epithelium, lamina propria papillae, intraepithelial eosinophils, and gastric cardia and body/fundic mucosa epithelia. Based on the major import of whole organ, cellular-level microscopy to obviate sampling error and the clear cost and convenience advantages of unsedated procedure, we believe that this tool has the potential to become a simpler and more effective device for diagnosing and monitoring the therapeutic response of EoE and other esophageal diseases.
食管胃十二指肠镜检查（EGD）是一种广泛应用的方法，给医疗保健系统和患者都带来了巨大的经济负担。此外，EGD 耗时较长，有时难以耐受，并且由于采集的活检数量有限，无法代表整个器官，因此诊断效果并不完美。在本文中，我们报告了一种可吞咽的系绳式内窥胶囊的技术和临床可行性，该胶囊无需镇静即可使用，能够以细胞水平对食管和胃黏膜的大片区域进行成像。为了展示成像能力，我们对嗜酸性食管炎（EoE）患者和健康志愿者进行了一项人体初步研究（n=17），并呈现和讨论了代表性病例。结果表明，与内镜活检相比，非镇静系绳式胶囊内窥检查可获得数量级更多的细胞信息，同时成功解析了具有特征性的组织微观特征，如复层鳞状上皮、固有层乳头、上皮内嗜酸性粒细胞以及胃贲门和体/底黏膜上皮。基于整个器官、细胞水平显微镜的重要作用可以避免采样误差，以及非镇静程序的明显成本和便利性优势，我们相信，这种工具有可能成为一种更简单、更有效的诊断和监测 EoE 及其他食管疾病治疗反应的工具。
