数字染色内镜在Barrett食管诊断中的应用

Digital chrome endoscopy for diagnosis of Barrett's esophagus

目的:探讨数字染色内镜(digital chrome endoscopy,I-Scan)对Barrett食管(Barrett's esophagus,BE)的诊断价值.方法:420例临床拟诊为胃食管反流性患者随机分为两组,患者分别接受I-Scan和普通内镜模式检查,筛选出疑似BE患者,并行病理检查,比较I-Scan组和对照组BE检出率以及图像特点.结果:I-Scan组疑诊BE患者35例,检出率为15.91%(35/220),病理确诊31例,符合率87.10%.对照组内镜疑诊B E 24例,检出率12.00%(24/200),病理确诊17例,符合率70.83%.I-Scan组与对照组相比,内镜疑似BE略有增高,但无统计学意义(P>0.05).I-Scan组对鳞、柱状上皮交界和胃食管结合部间距间栅状血管网图像清晰度与对照组相比有统计学差异(P<0.05).I-Scan组内镜疑似BE患者和病理诊断符合率、误诊率与对照组相比有统计学差异(P<0.05).结论:I-Scan对鳞、柱状上皮交界和胃食管结合部间距间栅状血管网的观察具有重要意义I-Scan模式诊断BE与病理诊断一致性好于普通内镜模式,I-Scan模式可以提高疑似BE的检出率.

AIM： To evaluate the diagnostic value of digital chrome endoscopy（I-Scan） in Barrett＇s esophagus（BE）.METHODS： From August 2012 to March 2013, a total of 420 patients with reflux esophageal disease were enrolled. The patients were randomized into two groups： one group（n = 220） received I-Scan and the other received ordinary endoscopy. Those suspected to have BE were observed closely and underwent biopsy. The detection rate and diagnostic accuracy were compared between the two endoscopic modes.RESULTS： Suspected BE was diagnosed in 35 patients（15.91%） by I-Scan and in 24（12.00%） by ordinary endoscopy. There was no significant difference in the detection rate for BE betweenthe two methods（P〉0.05）. The coincidence rate of diagnosis between I-Scan and pathology was 87.10%, and was 70.83% for the ordinary endoscopy, with a significant difference between the two groups（P〈0.05）. The image score of paliform blood vessels was significant difference between squamoucolumnar junction（SCJ） and gastroesophageal junction（GEJ）（P〈0.05）.CONCLUSION： I-Scan could play an important role in the observation of paliform blood vessels between SCJ and GEJ in BE. The dignostic rate of I-Scan might be better than that of ordinary endoscopy. I-Scan can improve the detection rate for BE.