共聚焦激光显微内镜对Barrett食管诊断价值的研究

目的 观察Barrett食管在共聚焦激光显微内镜下的形态学特征,评价共聚焦激光显微内镜对Barrett食管的诊断价值.方法 选取普通胃镜检查疑诊Barrett食管的患者,进行共聚焦激光显微内镜检查.对可疑或病变部位进行共聚焦内镜扫描,检查后即刻进行预测组织学诊断,即共聚焦激光显微内镜诊断.最后对扫描部位黏膜活检,将共聚焦激光显微内镜诊断与病理组织学诊断进行对比分析.结果 对入选的23例患者的73个部位进行共聚焦激光显微内镜扫描,结果显示共聚焦激光显微内镜诊断Barrett食管的灵敏度为95.6%,特异度为96.4%,阳性预测值为97.7%,阴性预测值为93.1%,诊断符合率为95.9%.结论 共聚焦激光显微内镜可以在内镜检查同时快速准确的诊断Barrett食管.

Evaluation of confocal laser endomicroscopy for diagnosis of Barrett's esophagus in vivo

Objective To evaluate the application of confocal laser endomicroscopy for diagnosis of Bar-rett's esophagus (BE) in vivo. Methods Patients suspected to suffer from BE by video endoscopy underwent examinations of esophagus with fluorescein-aided confocal endomicroscopy. Images obtained from each site were stored digitally and targeted biopsies were obtained at the same location. The results of confocal endoscopic ima-ges and pathological results of the biopsy were compared. Results A total of 73 mucosal sites in 23 patients were examined by confocal endomicroscopy. Confocal endomicroscopy revealed Barrett' s esophagus with the sensitivity of 95.6%, the specificity of 96.4%, the positive predictive value of 97.7%, the negative predic-tive value of 93.1%, and the accuracy of 95.9%. Conclusion Confoeal endomicroscopy can diagnose BE in vivo with high accuracy and can facilitate rapid diagnosis of BE during routine endoscopy.