共聚焦内镜对上消化道黏膜病变诊断价值的初步研究

目的初步探讨共聚焦内镜对上消化道黏膜病变的诊断价值。方法应用共聚焦内镜对9例患者进行常规胃镜检查,对正常黏膜和可疑病变部位用共聚焦内镜观察,与相应病变部位活检的病理学结果进行比较分析。结果对患者74个部位进行共聚焦扫查,采集图像1587帧,其中正常黏膜39个,慢性胃炎31个,食管癌3个,食管异位胃黏膜1个。不同部位和病变黏膜的共聚焦图像具有不同的形态学特点,共聚焦内镜对慢性胃炎患者胃黏膜肠上皮化生诊断的敏感性、特异性和准确性分别为85.7%、95.8%和93.5%。结论共聚焦内镜能显示上消化道黏膜的组织和细胞形态,对胃黏膜肠上皮化生的诊断具有较高的准确度。

Primary study of using confocal endoscopy in diagnosis of mucosal lesions in upper gastrointestinal tract

Objective] To explore the possibility of diagnosing mucosal lesions in upper gastrointestinal tract by confocal endoscopy. Methods] Nine patients underwent confocal gastroendoscopy were involved in the study. Normal mucosa and suspected lesions were observed by confocal endoscopy and compared with corresponding histopathological results. Results] 1587 confocal images were captured from 74 sites, which included 39 sites of normal mucosa, 31 sites of chronic gastritis, 3 sites of esophageal squamous cell carcinoma and 1 site of ectopic gastric mucosa in esophagus. Different sites and lesions had corresponding morphological features by confocal endoscopy. The sensitivity, specificity and accuracy in the diagnosis of intestinal metaplasia of gastric mucosa were 85.7%, 95.8% and 93.5%, respectively. Conclusion] Confocal endoscopy may display the histological and cytological features of the upper gastrointestinal tract mucosa. It is a valuable method for the diagnosis of intestinal metaplasia of gastric mucosa.