窄带成像放大内镜下食管黏膜微血管形态观察的临床价值

Clinical value of narrow-band imaging system with magnifying endoscopy for capillary pattern classification of esophageal lesions

目的探讨窄带成像放大内镜(NBI-ME)技术在食管黏膜微血管形态分型及其临床价值。方法应用NBI-ME技术对52例食管病变患者进行检查,观察食管黏膜上皮乳头内毛细血管袢(intraepithelial papillary capillary loop,IPCL)形态,并于各不同形态处行活组织检查。结果食管炎的IPCL主要呈Ⅱ型,为88.00%,低级别黏膜内瘤变的IPCL呈Ⅱ、Ⅲ型,Ⅱ型为43.75%,Ⅲ型为56.25%,高级别黏膜内瘤变的IPCL主要呈Ⅲ型,为83.33%,食管癌的IPCL主要呈Ⅳ型,为100%。结论通过NBI-ME对4种食管黏膜IPCL的形态观察可以推测病理组织学诊断,提高镜下诊断早期食管癌及癌前病变的准确率,以指导正确的治疗方法及镜下随诊。

Objective To evaluate the clinical value of narrow-band imaging system with magnifying endoscopy （NBI-ME） for capillary pattern classification of esophageal lesions. Methods Esophageal lesions of 52 patients were examined by NBI-ME, IPCL pattern diagnosis was made for every lesion, biopsy examination was made in different pat- tern. Results IPCL patterns of esophagitis were main type Ⅱ （88.00%） , IPCL patterns of low grade neoplastic le- sion were main type Ⅱ ,Ⅲ ,type Ⅱ （43.75%） ,typeⅢ （56.25%） , IPCL patterns of high grade neoplastic lesion were main type Ⅲ, type Ⅲ （83.33%） ,IPCL patterns of esophageal cancer were main type Ⅳ （ 100% ）. Conclusion The observation of IPCL pattern in esophageal lesions by NBI-ME can roughly predict histopathological diagnosis, improve the accurate rate of esophageal cancer and precancerous lesions, direct a correct treatment and follow-up by endoscopy.