TY - T1的放大chromoendoscopy检测肠上皮化生和不典型增生的巴雷特食管的JF -肠道乔-肠道SP - 24 LP - 27 - 10.1136 / gut.52.1.24六世52 - 1 AU -沙玛,P AU -韦斯顿,P盟——Topalovski M盟——Cherian R AU - Bhattacharyya,非盟——Sampliner, R E Y1 - 2003/01/01 UR - //www.marcconsult.com/content/52/1/24.abstract N2 -背景:柱状排列的食管远端肠化生(IM)的存在确定了Barrett食管未来恶性转化的风险。在柱状排列的食管内，IM和发育不良(低级别(LGD)和高级别(HGD))的分布呈斑块状和马赛克状，需要随机活检。在巴雷特粘膜内靶向高产区域的技术是有帮助的。目的:探讨高倍色内窥镜(MCE)在Barrett食管IM、LGD、HGD检测中的应用价值。方法:采用Olympus放大内窥镜(GIF-Q16OZ, 115×)连续观察食管远端柱状黏膜。用靛蓝胭脂红溶液喷洒食管远端，高倍镜下观察食管柱状黏膜，并进行活检。所有的活检都是由对内窥镜检查结果不知情的病理学家阅读的。结果:研究了80例疑似Barrett食管(即食管远端柱状排列)患者，平均年龄62.7岁(35-81岁)。柱状黏膜平均长度3.7 cm(范围0.5-17)。 Three types of mucosal patterns were noted within the columnar mucosa after spraying indigo carmine and using MCE: ridged/villous pattern, circular pattern, and irregular/distorted pattern. The yield of IM on target biopsies according to the patterns was: ridged/villous 57/62 (97%) and circular 2/12 (17%). Six patients had an irregular/distorted pattern and all had HGD on biopsy (6/6 (100%)). Eighteen patients had LGD on target biopsies; all had the ridged/villous pattern. All patients with long segment Barrett’s were identified using MCE whereas 23/28 patients (82%) with short segment Barrett’s had the ridged/villous pattern. Conclusions: MCE helps visually identify areas with IM and HGD having specific patterns but not patients with LGD (appear similar to IM). MCE may be a useful clinical tool for the increased detection of patients with IM as well as for surveillance of patients for the detection of HGD. If these preliminary results are validated, MCE would help identify high yield areas, potentially eliminating the need for random biopsies. ER -