光学相干断层扫描技术用于食管早癌浸润深度判断的前瞻性研究

目的 评价光学相干断层扫描(OCT)技术用于食管早癌浸润深度判断的准确性,并将OCT与放大内镜联合窄带成像(ME-NBI)在食管早癌浸润深度评估过程中的表现进行比较分析。方法 本前瞻性研究纳入对象为2018年4月至2019年6月在解放军总医院第一医学中心行内镜黏膜下膜剥离术(ESD)前接受OCT及ME-NBI评估的28例食管早癌患者。根据检查过程中获得的OCT和ME-NBI图像,对病变浸润深度进行实时判断。以术后病理结果为金标准,比较OCT和ME-NBI两种方法对于食管早癌浸润深度判断的准确性,检查操作过程所需时间及并发症也一并进行分析。 结果 OCT和ME-NBI对28例食管早癌浸润深度判断的整体准确率分别为67.9%(19/28)和75%(21/28),两者差异无统计学意义(P>0.05)。OCT对浸润至上皮层/固有层(EP/LPM)病变评估的准确率为78.9%(15/19),与ME-NBI相比(68.4%,13/19),差异无统计学意义(P>0.05)。OCT评估过程所需时间为6.0±2.9min,显著短于ME-NBI的16.3±5.4min(P<0.001)。 结论 OCT在评估食管早癌浸润深度及筛选位于上皮层/固有层(EP/LPM)食管早癌准确率上,与ME-NBI能力基本一致,且所需时间更短。

A prospective study of optical coherence tomography for invasion depth prediction of early esophageal cancer

Objective To evaluate the accuracy of optical coherence tomography(OCT)for invasion depth prediction of early esophageal cancer(EEC) and compare the clinical outcoming of OCT with magnifying endoscopy-narrow band imaging (ME-NBI)in assessment procedure. Methods Twenty-eight patients who were diagnosed with EEC and accepted OCT and ME-NBI assessment before endoscopic submucosal dissection(ESD)were enrolled in this prospective study. On the basis of the OCT and ME-NBI images, real-time prediction of EEC invasion depth was made. Postoperative pathological results were taken as golden standard to compare the accuracy of OCT with ME-NBI in evaluation of EEC invasion depth. The procedure time and complications during evaluation process were analyzed in the meantime. Result The overall accuracy of OCT and ME-NBI in predicting invasion depth of 28 EEC patients was 67.9%(19/28)and 75%(21/28)respectively,with no significant difference(P>0.05). The accuracy of OCT in distinguishing EP/LPM lesions was 78.9%(15/19). There was no significant difference compared with ME-NBI 68.4%(13/19,P>0.05). The procedure time of OCT was significantly shorter than that of ME-NBI [(6.0±2.9)min VS(16.3±5.4)min,P<0.001]. Conclusion The assessment ability of OCT in predicting invasion depth of EEC and distinguishing lesions located in the EP/LPM is comparable to the ME-NBI. Besides,OCT requires shorter procedure time for evaluation.