Vasapolli Riccardo, Westphal Johannes Raphael, Schulz Christian
Medical Department II, University Hospital LMU Munich, 81377 Munich, Germany.
DZIF Deutsches Zentrum für Infektionsforschung, Partner Site Munich, 81377 Munich, Germany.
Diagnostics (Basel). 2025 Jul 31;15(15):1925. doi: 10.3390/diagnostics15151925.
Chronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies. In the absence of clear mucosal changes observed through white-light imaging (WLI) or virtual chromoendoscopy, endocytoscopy can help unveil the presence of GPC by enabling in vivo assessment of nuclear and cellular structures at ultra-high magnification. Endocytoscopy is typically performed using WLI following dye-based staining of the mucosa. In this case, we demonstrate that combining endocytoscopy with the texture and color enhancement imaging (TXI) mode substantially improves the assessment of the gastric mucosa. In a 61-year-old man undergoing esophagogastroduodenoscopy, WLI showed multifocal erythema in the stomach, without clearly visible lesions on either WLI or narrow-band imaging. Conventional endocytoscopy revealed multiple small spots of IM with characteristic changes in glandular structures, which were even more evident when using the TXI mode. Histological analysis of targeted biopsies confirmed small foci of IM in both the antrum and corpus. The patient was enrolled in a surveillance program because of his clinical background. The combination of endocytoscopy with the TXI mode significantly enhances the delineation of mucosal and cellular architecture, supporting a more accurate optical diagnosis.
慢性萎缩性胃炎和肠化生(IM)是与胃癌风险增加相关的胃癌前病变(GPC)。因此,GPC的早期检测和准确特征描述对于风险分层和预防策略的实施至关重要。在白光成像(WLI)或虚拟色素内镜检查未观察到明显黏膜变化的情况下,内镜细胞成像可通过在超高倍率下对细胞核和细胞结构进行体内评估,帮助揭示GPC的存在。内镜细胞成像通常在对黏膜进行基于染料的染色后,使用WLI进行。在此,我们证明将内镜细胞成像与纹理和颜色增强成像(TXI)模式相结合可显著改善对胃黏膜的评估。在一名接受食管胃十二指肠镜检查的61岁男性中,WLI显示胃内有多灶性红斑,在WLI或窄带成像上均未发现明显可见的病变。传统内镜细胞成像显示多个IM小斑点,其腺体结构有特征性变化,在使用TXI模式时更为明显。靶向活检的组织学分析证实胃窦和胃体均有IM小病灶。由于其临床背景,该患者被纳入监测项目。内镜细胞成像与TXI模式的结合显著增强了对黏膜和细胞结构的描绘,有助于进行更准确的光学诊断。
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