Mortensen Olivia Engholt, Nerup Nikolaj, Thorsteinsson Morten, Svendsen Morten Bo Søndergaard, Shiwaku Hironari, Achiam Michael Patrick
Department of Surgical Gastroenterology, Copenhagen University Hospital, Copenhagen 2100, Denmark.
Copenhagen Academy for Medical Education and Simulation, Copenhagen University Hospital, Copenhagen 2100, Denmark.
World J Gastrointest Endosc. 2020 Oct 16;12(10):388-400. doi: 10.4253/wjge.v12.i10.388.
Conventional endoscopy is based on full spectrum white light. However, different studies have investigated the use of fluorescence based endoscopy systems where the white light has been supplemented by infrared light and the use of relevant fluorophores. Fluorescence endoscopy utilizes the fluorescence emitted from a fluorophore, visualizing what is not visible to the naked eye.
To explore the feasibility of fluorescence endoscopy and evaluate its use in diagnosing and evaluating gastrointestinal disease.
We followed the PRISMA guidelines for this systematic review. The research covered five databases; PubMed, Scopus, Web of Science, Embase, and the Cochrane Collection, including only studies in English and Scandinavian languages. Authors screened title and abstract for inclusion, subsequently full-text for inclusion according to eligibility criteria listed in the protocol. The risk of bias was assessed for all studies according to the Newcastle-Ottawa Scale. The authors extracted the data and reported the results in both text and tables.
We included seven studies in the systematic review after screening a total of 2769 papers. The most prominent fluorophore was indocyanine green ( = 6), and whereas one study ( = 1) used Bevacizumab 800-CW. Three studies investigated fluorescence endoscopy in detecting varices, adenomas in patients with familial adenomatous polyposis and neoplasms in the gastrointestinal tract. Four studies evaluated the usefulness of fluorescence endoscopy in assessing tumor invasion. Three of the four studies reported an exceptional diagnostic accuracy (93%, 89% and 88%) in assessing tumor invasion, thus representing better visualization and more correct diagnosis by fluorescence endoscopy compared with the conventional endoscopy. The relationship between the endoscopic findings, tumor invasion, and tumor vascularity was evaluated in two studies showing a significant correlation ( < 0.05 and < 0.01).
The use of fluorescence endoscopy is a promising method adding diagnostic value in the detection of neoplasia, adenomas, and assessment of tumor invasion within the gastrointestinal tract. More studies are needed to utilize the feasibility of fluorescence endoscopy compared with other endoscopic methods.
传统内窥镜检查基于全光谱白光。然而，不同的研究已经对基于荧光的内窥镜系统的应用进行了调查，在这些系统中，白光由红外光和相关荧光团补充。荧光内窥镜检查利用荧光团发出的荧光，使肉眼不可见的东西可视化。
探讨荧光内窥镜检查的可行性，并评估其在诊断和评估胃肠道疾病中的应用。
我们遵循PRISMA指南进行这项系统评价。研究涵盖五个数据库；PubMed、Scopus、科学网、Embase和考科蓝图书馆，仅包括英文和斯堪的纳维亚语的研究。作者先筛选标题和摘要以确定是否纳入，随后根据方案中列出的纳入标准筛选全文。根据纽卡斯尔-渥太华量表对所有研究进行偏倚风险评估。作者提取数据并以文本和表格形式报告结果。
在总共筛选了2769篇论文后，我们在系统评价中纳入了七项研究。最突出的荧光团是吲哚菁绿（n = 6），而一项研究（n = 1）使用了贝伐单抗800-CW。三项研究调查了荧光内窥镜检查在检测静脉曲张、家族性腺瘤性息肉病患者的腺瘤和胃肠道肿瘤方面的应用。四项研究评估了荧光内窥镜检查在评估肿瘤浸润方面的有用性。四项研究中的三项报告了在评估肿瘤浸润方面具有出色的诊断准确性（93%、89%和88%），因此与传统内窥镜检查相比，荧光内窥镜检查显示出更好的可视化效果和更准确的诊断。两项研究评估了内窥镜检查结果、肿瘤浸润和肿瘤血管生成之间的关系，显示出显著相关性（P < 0.05和P < 0.01）。
荧光内窥镜检查的应用是一种有前景的方法，在胃肠道肿瘤、腺瘤的检测以及肿瘤浸润的评估中增加了诊断价值。与其他内窥镜检查方法相比，需要更多的研究来利用荧光内窥镜检查的可行性。
