Barrett食管的内镜诊断技术应用进展

发布时间：2018-04-01 16:10

本文选题：Barrett食管　切入点：纤维内镜　出处：《山东医药》2016年31期

【摘要】：Barrett食管(BE)是食管腺癌的癌前病变。传统诊断BE的方法为常规内镜检查结合病理活检,但普通内镜可能漏检早期食管腺癌,且活检创伤较大,耗时长,可能产生取材误差。近年来一些新的内镜诊断技术得到开展和应用。染色内镜可在一定程度提高BE肠上皮化生、不典型增生的检出率,但操作相对繁琐、耗时。增强放大内镜能够提高肠上皮化生的检出率,单用于诊断BE效果并不理想。窄带成像技术(NBI)在诊断BE的异型增生方面有高度准确性。激光共聚焦显微内镜(CLE)对BE中重度不典型增生和黏膜内癌的诊断效能较好,但检查所需时间和成本较高。食管胶囊内镜(SCE)可以成为诊断BE的重要手段,然而胶囊价格较为昂贵,且SCE在评估BE的长度和类型方面效能一般。光学相干断层摄影术(OCT)和自体荧光成像(AFI)诊断BE的假阳性率较高,应用受到限制。
[Abstract]:Barrett esophagus is a precancerous lesion of esophageal adenocarcinoma.The traditional method for diagnosis of be is routine endoscopic examination combined with pathological biopsy, but common endoscopy may fail to detect early esophageal adenocarcinoma, and the biopsy is more traumatic and time-consuming, which may result in errors in the selection of materials.In recent years, some new endoscopic diagnostic techniques have been developed and applied.Staining endoscopy can improve the detection rate of be intestinal metaplasia and atypical hyperplasia to some extent, but the operation is relatively cumbersome and time-consuming.Enhanced magnification endoscopy can improve the detection rate of intestinal metaplasia.Narrowband imaging technique (NBI) is highly accurate in the diagnosis of be dysplasia.Laser confocal microendoscopy (CLEs) was effective in the diagnosis of moderate and severe atypical hyperplasia of be and intramucosal carcinoma, but the time and cost of examination were higher.Esophageal capsule endoscopy can be an important method in the diagnosis of be. However, the price of capsule is relatively high, and the efficacy of SCE in evaluating the length and type of be is mediocre.The false positive rate of optical coherence tomography (Oct) and autofluorescence imaging (AFI) in the diagnosis of be is high and its application is limited.
【作者单位】：贵港市人民医院;
【分类号】：R571

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