食管腺癌图像增强内镜检查的未来

Future of image enhanced endoscopy of esophageal adenocarcinoma.

作者信息

Parlar Kerem, Cakir Mert, Ozer Ozlem, Sharma Prateek

机构信息

Department of Internal Medicine, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey.

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Istanbul Demiroglu Bilim University Faculty of Medicine, Istanbul, Turkey.

出版信息

Clin Endosc. 2025 Jul;58(4):503-513. doi: 10.5946/ce.2024.324. Epub 2025 May 20.

Abstract

Barrett's esophagus is a premalignant precursor lesion of esophageal adenocarcinoma that affects approximately 1% of the population worldwide. Esophageal adenocarcinoma has a high mortality rate with a five-year survival of 15% to 20%. Early detection of Barrett's esophagus and dysplasia via endoscopy is crucial for preventing its progression to esophageal adenocarcinoma. New imaging techniques, such as image-enhanced endoscopy, have simplified the identification of Barrett's esophagus, dysplasia, and esophageal adenocarcinoma. Narrow-band imaging, blue-light imaging, and i-Scan are the prominent image-enhanced endoscopic techniques used to detect neoplasia. In Barrett's screening and surveillance, key aspects such as the screening population, tools, and intervals need to be clearly defined and standardized for future guidelines to improve the detection of precursor lesions and reduce the incidence of esophageal adenocarcinoma. Making image-enhanced endoscopy less subjective and enhancing the quality measures during endoscopy are crucial steps. Examples of quality measures include cleaning the esophagus before endoscopy and allowing sufficient time for inspection. Artificial intelligence systems can aid the early identification of lesions and reduce subjectivity.

摘要

巴雷特食管是食管腺癌的一种癌前病变,全球约1%的人口受其影响。食管腺癌死亡率高,五年生存率为15%至20%。通过内镜检查早期发现巴雷特食管和发育异常对于预防其进展为食管腺癌至关重要。新的成像技术,如图像增强内镜检查,简化了巴雷特食管、发育异常和食管腺癌的识别。窄带成像、蓝光成像和i-Scan是用于检测肿瘤形成的突出的图像增强内镜技术。在巴雷特食管的筛查和监测中,筛查人群、工具和间隔等关键方面需要明确界定并标准化,以便未来制定指南,提高癌前病变的检测率并降低食管腺癌的发病率。使图像增强内镜检查减少主观性并提高内镜检查期间的质量控制措施是关键步骤。质量控制措施的例子包括在内镜检查前清洁食管并留出足够的检查时间。人工智能系统可以帮助早期识别病变并减少主观性。

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