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巴雷特食管监测中的高级影像学：是否物有所值？

Advanced imaging in surveillance of Barrett's esophagus: Is the juice worth the squeeze?

机构信息

Division of Gastroenterology, Long Island Jewish Medical Center, Zucker School of Medicine at Hofstra/Northwell, Northwell Health System, New Hyde Park, NY 11040, United States.

出版信息

World J Gastroenterol. 2019 Jul 7;25(25):3108-3115. doi: 10.3748/wjg.v25.i25.3108.

DOI:10.3748/wjg.v25.i25.3108
PMID:31333304
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6626724/
Abstract

Esophageal cancer is on the rise. The known precursor lesion is Barrett's esophagus (BE). Patients with dysplasia are at higher risk of developing esophageal cancer. Currently the gold standard for surveillance endoscopy involves taking targeted biopsies of abnormal areas as well as random biopsies every 1-2 cm of the length of the Barrett's. Unfortunately studies have shown that this surveillance can miss dysplasia and cancer. Advanced imaging technologies have been developed that may help detect dysplasia in BE. This opinion review discusses advanced imaging in BE surveillance endoscopy and its utility in clinical practice.

摘要

食管癌发病率呈上升趋势。已知的癌前病变是巴雷特食管（BE）。有异型增生的患者发生食管癌的风险更高。目前，监测内镜的金标准包括对异常区域进行靶向活检，以及对 BE 长度每 1-2 厘米进行随机活检。遗憾的是，研究表明这种监测可能会遗漏异型增生和癌症。已经开发出了一些先进的成像技术，这些技术可能有助于检测 BE 中的异型增生。本综述讨论了 BE 监测内镜中的先进成像技术及其在临床实践中的应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/875fe07083d9/WJG-25-3108-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/06619a14a447/WJG-25-3108-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/51b06ee87264/WJG-25-3108-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/d0fbfd404226/WJG-25-3108-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/ef05a9121311/WJG-25-3108-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/875fe07083d9/WJG-25-3108-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/06619a14a447/WJG-25-3108-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/51b06ee87264/WJG-25-3108-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/d0fbfd404226/WJG-25-3108-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/ef05a9121311/WJG-25-3108-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cec1/6626724/875fe07083d9/WJG-25-3108-g005.jpg

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本文引用的文献

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Incremental yield of dysplasia detection in Barrett's esophagus using volumetric laser endomicroscopy with and without laser marking compared with a standardized random biopsy protocol.与标准随机活检方案相比，使用带有和不带有激光标记的容积激光内窥镜检查 Barrett 食管中的异型增生的增量收益。
Gastrointest Endosc. 2018 Jul;88(1):35-42. doi: 10.1016/j.gie.2018.01.032. Epub 2018 Feb 2.
2
Learning curve and competence for volumetric laser endomicroscopy in Barrett's esophagus using cumulative sum analysis.使用累积和分析评估 Barrett 食管中容积激光内窥技术的学习曲线和能力。
Endoscopy. 2018 May;50(5):471-478. doi: 10.1055/s-0043-121569. Epub 2017 Nov 27.
3
Volumetric laser endomicroscopy in the management of Barrett's esophagus.
容积激光内镜检查在巴雷特食管管理中的应用
Curr Opin Gastroenterol. 2017 Jul;33(4):254-260. doi: 10.1097/MOG.0000000000000366.
4
Feasibility of laser marking in Barrett's esophagus with volumetric laser endomicroscopy: first-in-man pilot study.经内腔镜体层摄影术激光标记 Barrett 食管的可行性：首例人体初步研究。
Gastrointest Endosc. 2017 Sep;86(3):464-472. doi: 10.1016/j.gie.2017.01.030. Epub 2017 Feb 2.
5
Volumetric Laser Endomicroscopy in Patients With Barrett Esophagus.巴雷特食管患者的容积激光内镜检查
Gastroenterol Hepatol (N Y). 2016 Nov;12(11):719-722.
6
Volumetric laser endomicroscopy in Barrett's esophagus: interobserver agreement for interpretation of Barrett's esophagus and associated neoplasia among high-frequency users.食管 Barrett 内镜下体积激光显微成像：高频使用者对 Barrett 食管及其相关肿瘤的解读的观察者间一致性。
Gastrointest Endosc. 2017 Jul;86(1):133-139. doi: 10.1016/j.gie.2016.11.026. Epub 2016 Nov 27.
7
ASGE Technology Committee systematic review and meta-analysis assessing the ASGE Preservation and Incorporation of Valuable Endoscopic Innovations thresholds for adopting real-time imaging-assisted endoscopic targeted biopsy during endoscopic surveillance of Barrett's esophagus.ASGE 技术委员会系统评价和荟萃分析评估了 ASGE 保留和纳入有价值的内镜创新的标准，用于在 Barrett 食管的内镜监测中采用实时成像辅助的内镜靶向活检。
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8
White Paper AGA: Advanced Imaging in Barrett's Esophagus.AGA 白皮书：巴雷特食管的高级影像学。
Clin Gastroenterol Hepatol. 2015 Dec;13(13):2209-18. doi: 10.1016/j.cgh.2015.09.017. Epub 2015 Oct 14.
9
Comparative diagnostic performance of volumetric laser endomicroscopy and confocal laser endomicroscopy in the detection of dysplasia associated with Barrett's esophagus.容积激光内镜显微镜与共聚焦激光内镜显微镜在检测巴雷特食管相关异型增生中的诊断性能比较
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