共聚焦激光显微内镜问题1全文统一规范写法对Barrett食管诊断价值的研究.docVIP

共聚焦激光显微内镜（问题1：全文统一规范写法。）对Barrett食管诊断价值的研究 黄 锦1，杨云生1，韦立新2，卢忠生1，王淑芳1，孙 刚1，彭丽华1，令狐恩强1， 郭明洲1 （中国人民解放军总医院：1消化内科，2病理科，北京市 100853） 摘 要：目的 观察Barrett食管在共聚焦显微内镜下的形态学特征，评价共聚焦显微内镜对Barrett食管的诊断价值。 方法 选取普通胃镜检查疑诊Barrett食管的患者，进行共聚焦激光显微内镜检查。对可疑或病变部位进行共聚焦内镜扫描，检查后即刻进行预测组织学诊断，即共聚焦显微内镜诊断。最后对扫描部位黏膜活检，将共聚焦显微内镜诊断与病理组织学诊断进行对比分析。 结果 对入选的23例患者的73个部位进行共聚焦内镜扫描，共聚焦内镜诊断Barrett食管的灵敏度为95.6%，特异度为96.4%，阳性预测值为97.7%，阴性预测值为93.1%，诊断符合率为95.9%。 结论 共聚焦显微内镜可以在内镜检查同时快速准确的诊断Barrett食管。 关键词 Barrett食管；共聚焦显微内镜；诊断 中图法分类号：R443.8;R571 中图法分类号：A Evaluation of confocal laser endomicroscopy for diagnosis of Barrett’s esophagus in vivo HUANG Jin1，YANG Yun-sheng 1，WEI Li-xin2，LU Zhong-sheng1，WANG Shu-fang 1，SUN Gang 1，PENG Li-huang1，LINGHU En-qiang1， GUO Ming-zhou1. （1Department of Gastroenterology and Hepatology, 2Department of Pathology, Chinese PLA General Hospital , Beijing 100853, China） Abstract Objective To evaluate the application of confocal laser endomicroscopy for diagnosis of Barrett’s esophagus (BE) in vivo. Methods Consecutive patients who were suspected to have BE by video endoscopy were recruited. The patients underwent examinations of esophagus with fluorescein-aided confocal endomicroscopy. Images obtained from each site were stored digitally and targeted biopsies were obtained at the same location. The results of confocal endoscopic images and biopsy pathology were compared. Results A total of 73 mucosal sites in 23 patients were examined with confocal endomicroscopy. Barrett’s esophagus were revealed by confocal endomicroscopy with a sensitivity of 95.6%, specificity of 96.4%, positive predictive value of 97.7%, negative predictive value of 93.1%, and with accuracy of 95.9% Conclusion The confocal endomicroscopy can diagnose BE in vivo with high accuracy and can facilitate rapid diagnosis of BE during routine endoscopy. Key words Barrett’s esophagus; confocal; endomicroscopy Barrett食管（Barrett’s esophagus, BE）是胃食管反流病的一种并发症[1]，与食管腺癌的发生关系密切。BE的确诊需要病理学检查发现肠上皮化生，因此目前BE的诊断方法是电子内