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内镜超声检查术:上消化道的技术与临床应用

Endocytoscopy: technology and clinical application in upper gastrointestinal tract.

作者信息

Abad Mary Raina Angeli, Shimamura Yuto, Fujiyoshi Yusuke, Seewald Stefan, Inoue Haruhiro

机构信息

Digestive Diseases Center, Showa University Koto Toyosu Hospital, Tokyo, Japan.

Center of Gastroenterology, Klinik Hirslanden, Zurich, Switzerland.

出版信息

Transl Gastroenterol Hepatol. 2020 Apr 5;5:28. doi: 10.21037/tgh.2019.11.12. eCollection 2020.

Abstract

Over the past few years, the innovative field of magnifying endoscopy has been expanding with various cutting-edge technologies, one of which is endocytoscopy, to facilitate improvement in the detection and diagnosis of gastrointestinal lesions. Endocytoscopy is a novel ultra-high magnification endoscopic technique enabling high-quality assessment of lesions found in the gastrointestinal tract with the use of intraprocedural stains. The main scope of this review article is to offer a closer look at the latest endocytoscopic technology and its clinical application in the upper gastrointestinal tract, especially in the esophagus and stomach, as well as to introduce readers to our simplified and up-to-date endocytoscopic classification, specifically developed for the esophagus and stomach, for the assessment and diagnosis of esophageal and gastric lesions. Despite the good accuracy of endocytoscopy in the diagnosis of esophageal and gastric lesions in recent studies, some challenges still remain (e.g., staining method and standardized endocytoscopic classification). Through continuous evaluation and improvement of methods and skills, these challenges may be overcome thus establishing current techniques and classification, paving the way for further advances in the field of endocytoscopy and magnifying endoscopy. In all, endocytoscopy seems to aid in the diagnosis of gastrointestinal tract lesions and may, in the future, revolutionize the field of endoscopic diagnosis of gastrointestinal cancer, representing another step towards the so-called optical biopsy.

摘要

在过去几年中,放大内镜这一创新领域借助各种前沿技术不断发展,其中之一便是细胞内镜检查,以促进胃肠道病变检测与诊断水平的提高。细胞内镜检查是一种新型的超高倍率内镜技术,可通过术中染色对胃肠道发现的病变进行高质量评估。本文综述的主要内容是更深入地探讨细胞内镜检查的最新技术及其在上消化道,尤其是食管和胃中的临床应用,同时向读者介绍我们专门为食管和胃开发的、用于食管和胃病变评估与诊断的简化且最新的细胞内镜检查分类法。尽管近期研究表明细胞内镜检查在食管和胃病变诊断方面具有较高的准确性,但仍存在一些挑战(例如染色方法和标准化细胞内镜检查分类)。通过对方法和技术的持续评估与改进,这些挑战或许能够克服,从而确立当前的技术和分类法,为细胞内镜检查和放大内镜领域的进一步发展铺平道路。总体而言,细胞内镜检查似乎有助于胃肠道病变的诊断,并且在未来可能会彻底改变胃肠道癌症的内镜诊断领域,朝着所谓的光学活检又迈进了一步。

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