内镜下乙酸染色结合病理检查诊断Barrett食管

Diagnosis of barrett esophagus with instillation of acetic acid and biopsy

目的研究内镜下乙酸染色对于诊断Barrett食管(Barrett'sesophagus,BE)的帮助。方法用喷雾管在24例患者食管远端喷洒1.5%乙酸5～10mL,随后喷洒自来水50mL并进行观察。结果以1.5%乙酸喷洒食管远端黏膜,开始食管黏膜和胃黏膜都变白,约2、3min后观察,食管鳞状上皮仍是白色,柱状上皮变成微红色,并且柱状上皮周边有白色边缘。结论乙酸染色可指导微小或不易辨别的BE上皮的活检,提高对BE的诊断率,这种方法安全、迅速、价廉。

[Objective] To study the improvement on diagnosis of Barrett esophagus with instillation of acetic acid. [Methods] In 24 patients, 5 to 10 mL of 1.5% acetic acid was sprayed onto the distal esophagus using a spray catheter, followed immediately by spraying 50 mL tap water. [Resultsl Initially, a whitish coloration developed in both esophageal and gastric epithelia with the 1.5% acetic acid sprayed onto the distal esophagus. After 2 to 3 minutes, the esophageal squamous mucosa remained white but the columnar epithelium became reddish. Barrett＇s epithelium was outlined by a white rim. [Conclusions] Acetic acid instillation enhances the ability to detect small or indistinguishable islands of columnar epithelium of BE and to obtain targeted biopsy specimens. This method is safe, rapid, and inexpensive.