内镜智能分光比色技术对早期食管癌及癌前病变的诊断价值

目的 探讨内镜智能分光比色技术(FICE)对早期食管癌及癌前病变的诊断价值.方法 257例食管可疑病变患者分别接受FICE染色内镜、FICE染色放大内镜、2％ Lugol液染色内镜、2％ Lugol液染色放大内镜检查,并将内镜检查结果与活检病理结果进行对比分析.结果 FCIE染色内镜诊断早期食管癌的阳性率为92.6％(25/27),Lugol液染色内镜诊断早期食管癌的阳性率为88.9％ (24/27),两者比较差异无统计学意义(P=0.642);FICE染色放大内镜诊断早期食管癌的阳性率为96.3％(26/27),Lugol染色放大内镜诊断早期食管癌的阳性率为92.6％ (25/27),两者比较差异亦无统计学意义(P =0.556).FICE染色放大内镜可清晰观察乳头内毛细血管袢(IPCL)形态并进行分型,早期食管癌和高级别上皮内瘤变IPCL分型主要为Ⅳ和Ⅴ型,低级别上皮内瘤变和食管炎主要为Ⅱ和Ⅲ型,正常食管主要为Ⅰ型;而2％ Lugol液染色放大内镜尚不能清晰观察IPCL分型.FICE染色内镜模式下无不良反应发生;2％ Lugol液染色内镜下不良反应发生率为12.8％ (33/257).结论 FICE染色放大内镜能准确判断早期食管癌病理分型,提高食管癌及癌前病变的诊断率,是Lugol液染色内镜的有效补充.     

窄带成像放大内镜联合超声微探头诊断早期食管癌及癌前病变的价值

目的 研究窄带成像放大内镜联合超声微探头对早期食管癌及癌前病变的诊断价值.方法 58例经常规内镜观察有食管黏膜粗糙、糜烂、颜色异常、微隆起等可疑病变,首次病检均示慢性炎症患者,再次内镜检查时,对可疑病灶行微探头超声检查,在窄带成像放大内镜下观察病变部位上皮乳头内毛细血管袢的形态,并在其引导下对病变区行活组织病理检查,将放大内镜下毛细血管袢的形态结果与组织病理诊断对照研究后进行统计学分析.结果 58例常规内镜及活检为慢性炎症者经窄带成像放大内镜联合超声并在其引导下对病变区行活组织病理检查确诊鳞癌10例(17.24%),其中早期食管癌8例,高级别瘤变4例(6.89%),低级别瘤变16例(27.58%),食管炎28例(48.27%).食管癌组60.00%(6/10)为Ⅳ型上皮乳头内毛细血管袢(IPCL),40.00%(4/10)为Ⅲ型IPCL;高级别瘤变组75.00%(3/4)为Ⅲ型IPCL,25.00%(1/4)为Ⅳ型IPCL;低级别瘤变组,50.00%(8/16)为Ⅲ型IPCL,43.75%(7/16)为Ⅱ型IPCL,6.25%(1/16)为Ⅰ型IPCL;食管炎组85.18%(23/27)为Ⅱ型IPCL,11.11%(3/27)为Ⅰ型IPCL,3.71%(1/27)为Ⅲ型IPCL.食管癌、高级别瘤变的IPCL与食管炎的ILCL比较,差异有统计学意义(P<0.05).结论 窄带成像放大内镜联合超声微探头对早期食管癌及癌前病变有较高的诊断价值.     

内镜窄带成像技术在早期食管癌及癌前病变诊断中的应用

目的 探讨内镜窄带成像技术(NBI)在食管癌及癌前病变诊断中的价值.方法 对205例患者采用普通胃镜及胃镜NBI检查食管,病灶取病理活检,食管癌及中重度异型增生者进入本研究,比较普通胃镜及胃镜NBI对食管癌及中重度异型增生的诊断价值,分析食管癌及癌前病变的NBI表现.结果 普通放大胃镜不易观察到食管上皮内血管,NBI观察食管黏膜呈淡青色,放大观察可清楚地观察到茶色的食管上皮内血管及青色的深层血管.NBI观察早期食管癌及异型增生病灶呈茶色,病灶处深层血管不能显示.5例中重度异型增生及2例m1癌病灶的上皮乳头内血管环(IPCL)均表现为IPCL-Type Ⅳ-1型改变,2例m2癌为IPCL-Type Ⅳ-2型改变;3例m3及1例sm1癌为IPCL-Type Ⅳ-3型改变;3例sm2及8例进展期癌为IPCL-Type Ⅳ-4型改变.结论 NBI可观察食管黏膜及黏膜下的血管改变,较普通胃镜更易发现早期食管癌及癌前病变病灶.     

食管良性病变病理和预后的研究

目的探讨食管良性病变病理组织学类型和鳞癌及重度异型增生的发生率。方法对1997～2000年131例食管良性病变患者进行内镜形态观察与活检病理学检查,另取同期内镜检查食管正常者236例作为对照组。比较病理组织学变化,随访至2004年底,比较两组食管鳞癌和重度异型增生的发生率及相对危险度(RR)。结果食管良性病变根据内镜形态分为炎症糜烂型病变69例,平坦凹陷型病变21例和隆起型病变41例。病理组织学检查:正常或炎症上皮33例(25.19%),良性增生58例(44.27%)和轻中度异型增生40例(30.54%);对照组中,正常上皮181例(76.69%),良性增生55例(23.31%),无异型增生者。食管良性病变组中良性增生和轻中度异型增生明显高于对照组,而正常或炎症上皮明显低于对照组。食管良性病变组随访708人/年,鳞癌和重度异型增生分别发生21例和14例,共35例(4.94%)。对照组随访1315人/年,鳞癌和重度异型增生各发生1例,共2例(0.15%),食管良性病变组明显高于对照组。在食管良性病变中,良性增生和轻中度异型增生者鳞癌和重度异型增生发生率明显高于正常或炎症上皮。结论含有良性增生和轻中度异型增生的食管良性病变是食管鳞癌癌前状态。     

窄带成像放大内镜下食管黏膜微血管形态观察的临床价值

目的探讨窄带成像放大内镜(NBI-ME)技术在食管黏膜微血管形态分型及其临床价值。方法应用NBI-ME技术对52例食管病变患者进行检查,观察食管黏膜上皮乳头内毛细血管袢(intraepithelial papillary capillary loop,IPCL)形态,并于各不同形态处行活组织检查。结果食管炎的IPCL主要呈Ⅱ型,为88.00%,低级别黏膜内瘤变的IPCL呈Ⅱ、Ⅲ型,Ⅱ型为43.75%,Ⅲ型为56.25%,高级别黏膜内瘤变的IPCL主要呈Ⅲ型,为83.33%,食管癌的IPCL主要呈Ⅳ型,为100%。结论通过NBI-ME对4种食管黏膜IPCL的形态观察可以推测病理组织学诊断,提高镜下诊断早期食管癌及癌前病变的准确率,以指导正确的治疗方法及镜下随诊。     

NBI放大内镜联合超声内镜诊断早期食管癌23例分析

目的探讨NBI放大内镜联合超声内镜对早期食管癌的诊断价值。方法对2011年5月-2012年10月于第三军医大学大坪医院接受白光内镜、NBI放大内镜及超声内镜检查并针对早期食管癌患者进行回顾性分析。结果本组共23例患者,经病理诊断病灶共25处,食管原位鳞癌12处,食管黏膜内鳞癌4处,胃食管连接部黏膜内腺癌2处,食管高级别上皮内瘤变7处。25处病灶的食管上皮乳头内毛细血管形态(intra-epithelial papillary capillary loop,IPCL)分型为IPCL-Type-Ⅳ型、Ⅴ1型及Ⅴ2型为主23处,IPCL-Type-Ⅴ3和Ⅴn型改变为主2处。病灶超声内镜下表现为第1~3层结构增厚。结论 NBI放大内镜联合超声内镜有助于早期食管癌病变浸润深度的评价。     

智能分光染色放大内镜在胃平坦型病变诊断中的应用价值

目的:对胃平坦型病变进行富士能智能分光染色内镜(Fujinon intelligent chromoendoscopy,FICE)放大内镜观察,对比FICE放大内镜与病理检查的一致性,探讨FICE放大内镜在胃平坦型病变诊断中的应用价值.方法:2012-09/2014-08对江汉大学附属医院发现的248个胃黏膜平坦性病变进行富士能FICE放大内镜检查.在FICE及放大模式观察病灶腺管开口与毛细血管形态,对其形态进行分型,并结合整体内镜下表现预测病理诊断.将FICE放大内镜下的内镜判定结果与病理组织学结果进行对比,评价其一致性与关联性.FICE内镜与病理诊断的一致性评价采用Kappa检验.结果:萎缩在FICE内镜下主要表现为C、D、E型胃小凹形态;肠上皮化生在F I C E内镜下主要表现为D、E型胃小凹形态;高级别上皮内瘤变及早期癌在FICE内镜下主要表现为E、F型胃小凹形态.FICE放大内镜技术判定萎缩、肠上皮化生、异型增生及早期癌的结果与病理诊断的结果具有较好的一致性.结论:FICE放大内镜技术有助于对病变性质如炎症、萎缩、肠上皮化生、上皮内瘤变及早期癌等的判断,有较好的临床应用价值.     

FICE技术在胃镜中应用价值

[目的]探讨FICE技术在胃镜中的应用价值。[方法]100例接受胃镜检查的患者,分为FICE组50例,对照组50例。对照组在常规内镜下观察,FICE组先在常规内镜下观察,再在FICE技术下观察,针对病变形态、色泽、边缘、血管形态进行2组比较。[结果]FICE组50例中病理诊断胃癌5例、高级别上皮内瘤变5例、低级别上皮内瘤变8例、萎缩性胃炎22例、非萎缩性胃炎3例、食管癌3例、食管炎症或鳞状上皮增生4例,对照组分别为3例、2例、6例、16例、20例、0例、3例,除非萎缩性胃炎外,其他2组比较均差异有统计学意义(P0.05)。[结论]FICE技术可提高早期胃癌、早期食管癌的诊断率;提高病变与正常组织差异性,便于活检,提高胃镜检查的诊断率。     

上皮乳头内毛细血管袢形态在食管表浅型病变诊治中的应用

目的 探讨食管上皮乳头内毛细血管袢(IPCL)形态在食管表浅型病变诊治中的临床应用价值.方法 分析249处内镜下切除的表浅型食管病变资料,所有病变均根据井上晴洋方法进行IPCL分型,切除标本按照日本食道学会食管癌分级标准进行病理分析,探讨IPCL分型与病理间的关系.结果 249处病变中IPCLⅢ型22处,其中食管炎16处、低级别上皮内瘤变(LGIN)6处；IPCLⅣ型29处,其中食管炎11处、LGIN 4处、原位癌(m1)10处、肿瘤浸润黏膜内固有层(m2)4处；IPCL Ⅴ1型71处,其中m1期54处、m2期8处、肿瘤浸润黏膜肌层(m3)4处；IPCL Ⅴ2型48处,其中m1期8处、m2期34处、m3期4处；IPCL Ⅴ 3A型45处,其中m1期4处、m2期19处、m3期15处、肿瘤浸润黏膜下层上1/3(sm1)4处；IPCL Ⅴ3B型22处,其中m2期5处、m3期5处、sm1期3处、肿瘤浸润黏膜下层2/3(sm2)及以深9处；IPCL ⅤN型12处,其中sm1期2处、sm2及以深9处.结论 IPCL分型对食管表浅型病变的诊治有一定指导意义.IPCL Ⅴ1、Ⅴ2、Ⅴ,A型提示早期食管癌或m1～sm1期食管癌,可考虑行EMR或ESD; IPCL ⅤN型以sm2及以深食管癌多见；IPCLⅢ、Ⅳ、Ⅴ3B型病灶需要结合临床特点、活检、超声内镜等综合判定病灶性质或估计肿瘤浸润深度.     

内镜窄带成像技术在胃癌及癌前病变诊断中的应用

目的 探讨内镜窄带成像技术(NBI)对胃癌及癌前病变的诊断价值.方法 217例患者依次在普通内镜、NBI、0.2%靛胭脂染色及内镜放大(×80)模式下观察病变轮廓、胃小凹及微血管形态,评价各检查方法图像的清晰度,并结合病理学检查进行分析.结果 217例患者中,非萎缩性胃炎85例,萎缩性胃炎38例,轻度异型增生19例,中度异型增生9例,重度异型增生4例,早期胃癌5例,进展期胃癌20例,伴有肠化生者91例.NBI对病变轮廓的显示明显优于普通内镜和靛胭脂染色(P值均=0.000).经内镜放大后,NBI对胃微血管形态的显示亦优于普通内镜和靛胭脂染色(P值均=0.000).NBI模式下萎缩性胃炎胃小凹主要表现为Ⅲ、Ⅳ、Ⅴ1型,肠化生主要表现为Ⅲ、Ⅳ、Ⅴ1、Ⅴ2型,异型增生主要表现为Ⅴ1型及Ⅳ型,胃癌主要表现为Ⅵ型.结论 NBI电子染色结合放大技术有助于提高胃癌及异型增生的活检准确率和早期胃癌检出率.     

Gastroesophageal reflux: the features in elderly patients

INTRODUCTlONWiththeintroduction0fintraesophageal24-hpH-m0nitoringinclinicalpractice,itisnowpossibletoidentifypatternsofgastroesophagealreflux(GER)inthehealthypeopleandpatientsandtoassesstheeffectofH2blockersandH oc adenosinetriphosphatase(ATPase)inhibitorsonGERdiseasesL1Ai7I.ItisincreasinglyrecognizedthatsymptomaticGERmayoccurinthepatients0fallages.However,littleinformationisavailableonsymptomaticGERpatternsintheelderly.Recently,Moldetal,investigatedGERdisease(GERD)inpatientsag…     

Evaluation of microvascular patterns of superficial esophageal cancers by magnifying endoscopy

Background Endoscopic findings have traditionally been evaluated on the basis of differences in color and changes in surface structure. We examined whether microvascular patterns on magnifying endoscopy could be used to diagnose benign and malignant superficial esophageal lesions and to estimate the depth of tumor invasion. Methods Magnifying endoscopic findings were compared with histopathological features for 405 superficial lesions arising in the esophagus, including 191 esophageal cancers. Results Microvascular patterns on magnifying endoscopy were classified into 4 types. Type 1 was characterized by thin, linear capillaries in the subepithelial papilla and was generally seen in normal mucosa. Type 2 was characterized by distended, dilated vessels, and the shape of capillaries in the subepithelial papilla was preserved. Type 2 was generally seen in inflammatory lesions. Type 3 was characterized by spiral vessels with an irregular caliber and crushed vessels with red spots, and the arrangement of the vessels was irregular. Type 3 was generally seen in m1 or m2 cancers. Type 4 was characterized by multilayered, irregularly branched, reticular vessels with an irregular caliber. Type 4 was generally seen in cancers with m3 or deeper invasion. Avascular areas (AVAs) and stretched type 4 vessels were seen in cancers with downward growth. The size of AVAs was closely related to the depth of tumor invasion. Conclusions Histopathological features of superficial esophageal cancers can be diagnosed by evaluating microvascular patterns on magnifying endoscopy. The size of AVAs and associated type 4 vessels can be used to assess the extent and depth of tumor invasion.     

智能染色内镜诊断结肠病变腺管开口的临床价值及Ang-2表达、MVD值与腺管开口相关性研究

目的探讨FICE放大内镜对结肠瘤性、非瘤性病变的诊断价值以及血管生成素-2（Ang-2）表达、肿瘤微血管密度（MVD）与腺管开口的相互关系。方法选择富士能智能染色内镜（FICE）放大观查判定腺管开口为Ⅰ～Ⅴ型的结肠病变标本（Ⅰ～Ⅴ型各20例）,Ⅰ、Ⅱ型纳入A组,Ⅲ、Ⅳ型纳入B组,Ⅴ型纳入C组。对照病理诊断结果,判断FICE放大内镜对结肠病变的诊断价值。并采用免疫组化SP法分别测定不同腺管开口结肠病变中Ang-2表达情况及MVD值,分析3者间的相互关系。结果FICE放大内镜对非瘤性病变诊断的敏感性和特异性分别为88．0％和92．5％,符合率为90．2％;对瘤性病变诊断的敏感性和特异性分别为94．8％和91．7％,符合率为93．2％;对结肠病变诊断的总符合率为92．0％。结肠病变中Ang-2的阳性表达率和MVD值在A组（Ⅰ、Ⅱ型合并组）、B组（Ⅲ、Ⅳ型合并组）、C组（腺管开口V型）3组逐渐升高。且Ang-2阳性表达组MVD值明显增高。结论FICE放大内镜对结肠病变腺管开口分型的判断可基本准确区别瘤性、非瘤性病变,结肠病变中Ang-2的阳性表达、肿瘤血管的生成与其腺管开口关系密切。     

放大内镜下大肠黏膜腺管开口分型对早期大肠癌检出的意义

目的 评价腺管开口分型对早期大肠癌及癌前病变检出的临床价值.方法 回顾2004年11月至2007年8月结肠镜检查,采用内镜下黏膜染色技术,结合放大内镜及实体镜观察腺管开口分型并与病理诊断对照,腺管开口分型采用工藤进英分型标准.结果 结肠镜检杳大肠病变共1496个,非肿瘤性病变占30.6%(458/1496),各类型腺瘤占43.9%(657/1496),大肠癌占25.5%(381/1496).早期大肠癌61个;大肠侧向发育型肿瘤36个,直径10～62 mm,其中Ⅱ型3个,Ⅲ1.型14个,Ⅳ型17个,Ⅴ型2个.管状腺瘤中以低级别上皮内瘤变居多,占87.5%(363/415);管状绒毛状腺瘤高级别上皮内瘤变占40.7%(61/150);绒毛状腺瘤腺管开口以Ⅳ型为主,高级别上皮内瘤变达85.7%(42/49).结论 大肠腺管开口分型对于判断肿瘤性、非肿瘤性病变以及早期大肠癌的检出有重要意义,对及时进行内镜治疗或手术切除具有一定的临床指导意义.     

Magnifying endoscopic observation of superficial esophageal carcinoma

The depth of tumor invasion of esophageal cancers is one of the most important indicators for predicting lymph node metastasis, so much effort has been directed toward improving the diagnosis of tumor invasion, especially in cases of super?cial esophageal cancer. Ultra‐high magnifying endoscopic observation for esophageal cancer was performed using an Olympus Q240Z, which has a 100 × magnifying capacity. We succeeded in observing looped capillary vessels inside the papillae (intrapapillary capillary loop: IPCL). The IPCL inside an m1 cancer showed abnormal changes such as ‘dilation, weaving, changes in caliber, variety of shapes’. Furthermore, we found that super?cial esophageal cancers show characteristic changes according to the depth of invasion. In our investigation, the rate of accurate diagnosis using magnifying endoscopy for super?cial esophageal cancers was 83.1% in cases for which ?ne pictures were obtained. Observations of the microvascular architecture of super?cial esophageal carcinoma using magnifying endoscopy are useful for diagnosing the depth of tumor invasion, especially for super?cial cancers with invasion reaching to the muscularis mucosae (m3) and slightly into the submucosa (sm1) esophageal cancer.     

智能电子分光技术在判断幽门螺杆菌感染胃黏膜病变中的研究

目的通过智能电子分光技术（FICE）结合高分辨率放大内镜,描述正常及胃黏膜病变的特征性改变,并探讨其与幽门螺杆菌（H.pylori）及组织病理学的相关性。方法选择32例消化不良患者及5例正常志愿者,在内镜检查中分别于胃窦及胃体部行放大内镜及FICE观察,对胃黏膜按胃小凹形态做出相应分型（Ⅰ～Ⅲ型）,并行快速尿素酶^13C-尿素呼气试验及组织病理学检查。分析胃窦及胃体FICE下的分型对诊断H.pylori的价值,并对FICE观察部位的组织病理学改变（活动性、炎症度、萎缩、肠化）进行分级评估。结果对照组5例胃窦及胃体黏膜的FICE分型均为Ⅰ型,提示无H.pylori感染。研究组32例中,胃窦黏膜FICE分型为Ⅰ型14例,其中1例H.pylori感染（7．1％）;Ⅱ型13例中10例H.pylori感染（76．9％）,且9例同时有萎缩改变;Ⅲ型5例,均H.pylori感染,且3例同时有萎缩及肠化。胃窦黏膜各FICE分型间H.pylori感染情况的差异具有统计学意义（P〈0．01）;Ⅲ型结构与组织病理学诊断的一致性较好（kappa=0．890）。胃体黏膜FICE分型为Ⅰ型15例,其中1例H.pylori感染（6．7％）;Ⅱ型13例中11例（84．6％）H.pylori感染;Ⅲ型4例均存在H.pylori感染。胃体黏膜各FICE分型间H.pylori感染情况的差异具有统计学意义（P〈0．01）。组织病理学改变（炎症性、活动度、萎缩及肠化）的分级在无H.pylori感染组中显著低于H．pylori感染组（P〈0．01）。结论H.pylori感染与胃黏膜的炎症程度及萎缩、肠化生有明显相关性;FICE技术结合高分辨率放大内镜对预测H.pylori的存在及判断胃黏膜的病变具有一定临床价值。     

Clinicopathological features of minute pharyngeal lesions diagnosed by narrow-band imaging endoscopy and biopsy

AIM: To evaluate the utility of magnified narrow-band imaging (NBI) endoscopy for diagnosing and treating minute pharyngeal neoplasia.METHODS: Magnified NBI gastrointestinal examinations were performed by the first author. A magnification hood was attached to the tip of the endoscope for quick focusing. Most of the examinations were performed under sedation. Magnified NBI examinations were performed for all of the pharyngeal lesions that had noticeable brownish areas under unmagnified NBI observation, and an intrapapillary capillary loop (IPCL) classification was made. A total of 93 consecutive pharyngeal lesions were diagnosed as IPCL type IV and were suspected to represent dysplasia. Sixty-two lesions of approximately 1 mm in diameter were biopsied in the clinic, and 17 lesions with larger diameters were resected by endoscopic submucosal dissection (ESD) at the Hiroshima University Hospital. In addition to the histological diagnoses, the lesion diameters were microscopically measured in 45 of the 62 biopsies. Thirty-four of the 62 biopsied patients received endoscopic follow up.RESULTS: Minute pharyngeal lesions were diagnosed in 93 of approximately 3000 patients receiving magnified NBI examinations at the clinic. Of the 93 patients with IPCL type IV lesions, 80 were men, and 13 were women. Fifty-six were drinkers, and 57 were smokers. Two had esophageal cancer. Twenty-one lesions were located on the posterior hypopharyngeal wall, and 72 lesions were located on the posterior oropharyngeal wall. All 93 lesions were flat and showed similar findings in the magnified and unmagnified NBI examinations. Although almost all of the IPCL type IV lesions showed faint redness when examined under white light, it was difficult to diagnose the lesions using only this technique because the contrast was weaker than that achieved in the NBI examinations. Of the 93 lesions, only 3 had diameters greater than 2.1 mm. Sixty-two lesions of approximately 1 mm were biopsied in the clinic, whereas 17 larger lesions were treated by ESD at the Hiroshima University Hospital. Of the 79 pharyngeal lesions that were biopsied or resected by ESD, 5 were histologically diagnosed as high-grade dysplasia, 39 were diagnosed as low-grade dysplasia, and 39 were determined to be non-dysplastic lesions. There were no cancerous lesions. Histologically, abnormal cell size variations and increased nuclear size were observed in all of the high-grade dysplasia lesions, while the incidence of these findings in the low-grade dysplasia lesions was low. Of the 62 biopsied lesions, 45 were microscopically measurable. The measured diameters ranged from 0.1 to 2.0 mm. The dysplasia ratios increased with the diameters. A follow-up endoscopic examination of the 34 biopsied patients found the rate of complete resection by biopsy to be 79%. The largest lesion in which complete resection was expected was a low-grade dysplasia of 1.9 mm in diameter.CONCLUSION: Minute pharyngeal lesions suspected to be dysplasia that are identified by NBI magnifying endoscopy should be biopsied to determine the diagnosis and further treatment.     

Helpfulness of the combination of acetic acid and FICE in the detection of Barrett's epithelium and Barrett's associated neoplasias

AIM: To investigate the mucosal morphology in Barrett’s oesophagus by chromo and magnifying endoscopy.METHODS: A prospective pilot study at a tertiary medical centre was conducted to evaluate the use of acetic acid pulverisation combined with virtual chromoendoscopy using Fujinon intelligent chromoendoscopy (FICE) for semiological characterization of the mucosal morphology in Barrett’s oesophagus and its neoplastic complications. Upper endoscopy using high definition white light, 2% acid acetic pulverisation and FICE with high definition videoendoscopy were performed in 20 patients including 18 patients who presented with aspects of Barrett’s oesophagus at endoscopy examination. Two patients used as controls had normal endoscopy and histological results. Prospectively, videos were watched blind from histological results by three trained FICE technique endoscopists.RESULTS: The videos of patients with high-grade dysplasia showed an irregular mucosal pattern in 14% using high definition white light endoscopy and in 100% using acid acetic-FICE combined. Videos did not identify irregular vascular patterns using high definition white light endoscopy, while acid acetic-FICE combined visualised one in 86% of cases.CONCLUSION: Combined acetic acid and FICE is a promising method for screening high-grade dysplasia and early cancer in Barrett’s oesophagus.