醋酸染色联合内镜智能分光比色技术对检测Barrett食管上皮和Barrett相关性肿瘤的价值

Value of acetic acid combined with FICE in the detection of Barrett’s epithelium and Barrett’s associated neoplasias

摘要:

目的 探讨醋酸染色联合内镜智能分光比色技术（FICE）技术在Barrett食管（BE）和Barrett相关性肿瘤的作用。方法 选择60例经胃镜检查诊断为BE患者，分别采用普通模式、醋酸染色联合FICE模式对病变形态、腺管开口分型及毛细血管形态观察，对病变作出诊断，并与病理组织学诊断相比较。结果 醋酸联合FICE对BE腺管开口形态及毛细血管结构清晰度均优于普通放大内镜（P =0.00<0.05）；高级别上皮内瘤变和癌的病例中，不规则的黏膜形态在普通模式组和醋酸染色联合FICE组中的阳性率分别是16.7%、100%，不规则血管形态的阳性率分别是16.7%、83.3%；醋酸染色联合FICE对Barrett食管肿瘤性病变诊断符合率为93.3%、敏感性91.6%、特异性93.8%，与普通放大内镜相比在符合率、敏感性上差异有显著性（P <0.05）。结论 醋酸染色联合FICE可清楚观察BE黏膜病变形态、腺管开口形态及毛细血管结构，对于提高诊断Barrett相关性肿瘤病变的准确性具有良好的临床实用价值。

Abstract:

【Objective】 To detect the role of acetic acid combined with Fuji Intelligent Chromo Endoscopy in Barrett’s esophagus and Barrett's associated neoplasias. 【Methods】 60 endoscopic BE patients diagnosed were enrolled in our hospital. They were observed by common endoscopy, then acetic acid combined with FICE. The operative endoscopist observed mucosal morphology, pit pattern and capillary structure in suspicious area were used to identify and compare pathological histology diagnosis. 【Results】 Acetic acid combined with FICE on BE pit patterns and capillary structure definition were better than ordinary magnifying endoscopy. In the high-grade intraepithelial neoplasia and cancer cases, the positive rates of irregular mucosal morphology in common mode group and acetic acid combined with FICE were 16.7%, 100%, the positive rates of irregular vascular morphology were 16.7%, 83.3%.The coincidence rate of acetic acid combined with FICE on Barrett’s esophageal neoplasms diagnosis was 93.3%, a sensitivity of 91.6%, specificity of 93.8%, compared with ordinary magnifying endoscopy the accuracy and sensitivity were significantly different （P <0.05）. 【Conclusion】 Acetic acid combined with FICE can clearly observe BE mucosal lesion morphology, pit patterns and capillary structure can improve the diagnosis accuracy of Barrett associated neoplasias and should be of good clinical practical value.