高分辨率显微内镜对消化道正常黏膜的成像研究

发布时间：2018-10-12 17:22

【摘要】：目的总结消化道正常黏膜的高分辨率显微内镜(HRME)的图片特点。方法选择正常食道黏膜、胃黏膜、十二指肠黏膜、小肠黏膜和结肠黏膜活检标本各10例为研究对象,利用HRME分别对其进行成像观察,根据采集的HRME图片对不同部位的消化道正常黏膜进行描述性分析,总结其HRME图片特点。成像结束后所有标本常规行病理检查。结果 50例活检标本共获得1 284张HRME图片,经筛查后,留取400张图片用于结果分析。不同部位消化道正常黏膜的HRME图片特点如下:1食道黏膜:细胞排列规则,细胞核圆而亮,大小一致,核间距正常,每个视野里细胞的数量基本一致;2胃底黏膜:浅层可见腺体排列规则,呈分枝状。胃小凹开口呈圆形或类椭圆形,周边裂隙呈线样,细胞核排列规则;3胃窦黏膜:浅层可见胃小凹开口呈不规则形或管状,腺腔呈裂隙状,小凹周围细胞排列规则,细胞核小且分布密集;4十二指肠黏膜:可见绒毛呈宽大的指状,绒毛两侧有锯齿状凹陷,立体感明显,呈簇状排列,间隙呈裂隙状;5小肠黏膜:绒毛状结构较宽,间隙较宽大,数量较十二指肠少;6结肠黏膜:细胞核大小一致、形态规则,为圆形或椭圆形以及菊花状的腺体结构。所有标本病理结果均证实为正常黏膜。结论 HRME可以准确地辨别不同部位消化道正常黏膜,与病理结果比较,具有很高的一致性。
[Abstract]:Objective to summarize the image features of high-resolution endoscopic (HRME) of normal digestive tract mucosa. Methods biopsy specimens of normal esophagus mucosa, gastric mucosa, duodenal mucosa, small intestine mucosa and colon mucous membrane were selected as the study objects. HRME was used to observe the pathological changes of esophageal mucosa, gastric mucosa, duodenal mucosa, small intestine mucosa and colon mucosa respectively. According to the collected HRME images, the normal mucosa of digestive tract in different parts were analyzed and the characteristics of HRME images were summarized. Pathological examination was performed on all specimens after imaging. Results A total of 1 284 HRME images were obtained from 50 biopsy specimens. The characteristics of HRME images of normal mucosa of digestive tract were as follows: (1) esophageal mucosa: regular arrangement of cells, round and bright nucleus, uniform size, normal nuclear spacing. The number of cells in each field was basically the same; 2 gastric fundus mucosa: the superficial glands arranged regularly and branched. The opening of gastric fovea was round or ellipsoid, the peripheral fissure was linear, and the nuclei were arranged regularly. 3 gastric antral mucosa: the opening of gastric fovea was irregular or tubular in superficial layer, the glandular cavity was fissure, and the cells around the pit were arranged regularly. The nuclei were small and densely distributed; (4) duodenal mucosa: the villi showed broad finger shape, serrated indentation on both sides of the villi, obvious stereoscopically arranged in clusters and fissures in the interspace; (5) small intestinal mucosa: the villous structure was wider, and the gap was wider. The number of colonic mucosa was less than that of duodenum. 6 colonic mucosa: the nucleus was uniform in size and regular in shape with round or elliptic and chrysanthemum-like glandular structure. All specimens were confirmed as normal mucosa. Conclusion HRME can accurately distinguish normal mucous membrane in different parts of digestive tract, which is consistent with pathological results.
【作者单位】：武警总医院消化科;
【基金】：首都临床特色应用研究(No:Z141107002514099)
【分类号】：R57

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