内镜荧光检测巴雷特食管中的高级别异型增生。

Endoscopic fluorescence detection of high-grade dysplasia in Barrett's esophagus.

作者信息

Panjehpour M, Overholt B F, Vo-Dinh T, Haggitt R C, Edwards D H, Buckley F P

机构信息

Laser Center, Thompson Cancer Survival Center, Knoxville, Tennessee, USA.

出版信息

Gastroenterology. 1996 Jul;111(1):93-101. doi: 10.1053/gast.1996.v111.pm8698231.

DOI:10.1053/gast.1996.v111.pm8698231

PMID:8698231

Abstract

BACKGROUND & AIMS: Early detection and treatment of esophageal cancer in Barrett's esophagus may improve patient survival if dysplasia is effectively detected at endoscopy. Typically, four-quadrant pinch biopsy specimens are taken at 2-cm intervals. This study was conducted to determine whether laser-induced fluorescence spectroscopy could be used to detect high-grade dysplasia in patients with Barrett's esophagus.

METHODS

Four hundred ten-naonometer laser light was used to induce autofluorescence of Barrett's mucosa in 36 patients. The spectra were analyzed using the differential normalized fluorescence (DNF) index technique to differentiate high-grade dysplasia from either low-grade or nondysplastic mucosa. Each spectrum was classified as either premalignant or benign using two different DNF indices.

RESULTS

Analysis of the fluorescence spectra from all patients collectively using the DNF intensity at 480 nm (DNF480) index showed that 96% of nondysplastic Barrett's esophagus samples were classified as benign, all low-grade dysplasia samples as benign, 90% of high-grade dysplasia samples as premalignant, and 28% of low-grade with focal high-grade dysplasia samples as premalignant. Using the two DNF indices concurrently, all patients with any high-grade dysplasia were classified correctly.

CONCLUSIONS

Laser-induced fluorescence spectroscopy has great potential to detect high-grade dysplasia in Barrett's esophagus when using the DNF technique.

摘要

背景与目的

如果在内镜检查中能有效检测出发育异常，那么早期发现并治疗巴雷特食管中的食管癌可能会提高患者生存率。通常，每隔2厘米采集四象限钳取活检标本。本研究旨在确定激光诱导荧光光谱法是否可用于检测巴雷特食管患者的高级别发育异常。

方法

使用410纳米激光诱导36例患者巴雷特黏膜的自发荧光。采用差分归一化荧光（DNF）指数技术分析光谱，以区分高级别发育异常与低级别或无发育异常的黏膜。使用两种不同的DNF指数将每个光谱分类为癌前或良性。

结果

使用480纳米处的DNF强度（DNF480）指数对所有患者的荧光光谱进行综合分析显示，96%的无发育异常巴雷特食管样本被分类为良性，所有低级别发育异常样本为良性，90%的高级别发育异常样本为癌前，28%的伴有局灶性高级别发育异常的低级别样本为癌前。同时使用两种DNF指数，所有有任何高级别发育异常的患者均被正确分类。