窄带成像放大内镜在Barrett食管诊断中临床应用价值.docVIP

窄带成像放大内镜在Barrett食管诊断中的临床应用价值 　　【摘要】目的 探讨窄带成像放大内镜（NarrowbandImagingSystemwithMagnifyingEndoscopy，NBI-ME）在Barrett食管（Barrett’sesophagus， BE）诊断中的临床应用价值。方法 对152例普通内镜下高度怀疑BE者， 按普通内镜、NBI、放大顺序进行观察，BE粘膜的腺管开口形态及微细血管形态分型参考Goda分型，将NBI-ME对BE粘膜组织形态预测结果与实际病理诊断结果进行对比分析，统计SIM检出率。结果 NBI-ME下腺管开口为4型及5型者，SIM检出率90.5%-100%；血管形态为Ⅳ型及Ⅴ型者，SIM检出率88.6%-100%。NBI-ME下预测BE粘膜SIM44例（30.3%），实际病理诊断SIM42（28.9%），两者差异无统计学意义（P〉0.05）。结论 NBI-ME能较准确预测BE粘膜肠化生，提高SIM的检出率， 具有良好的临床实用价值 【关键词】Barrett食管；窄带成像放大内镜；肠上皮化生；诊断 Evaluation of NarrowbandImagingSystemwithMagnifyingEndoscopy in thediagnosis of Barrett’s esophagus Zhuang Hui-jun1，Shen Xu-de2，Chen Jin-zhong1，Yao Li-qing1 1.Department of Endoscopy Center， the first Affiliated Hospital ofXiamen University， Xia men， Fu jian361003； 2.Department of Gastroenterology， Affiliated Hospital of Xiamen University， Xia men，Fu jian 361003， P.R.China 【Abstract】 Objective To study the clinical application value of NarrowbandImagingSystemwithMagnifyingEndoscopy （NBI-ME） in the diagnosisof Barrett’s esophagus（BE）.Methods NBI-ME was performed in 152 patients with endoscopically diagnosedwith BE.Patients underwent both ordinaryendoscopy and NBI-ME endoscopy.The BE mucosal pit pattern and capillary forms was classified basedon Goda type. Analysis of the differences between the BE mucosal morphology prediction bied NBI-ME and pathological results.The detection rate of SIMwas calculated.Results SIM detection rate was 90.5%-100% in BE mucosa with 4tipe and 5tipe mucosal pit pattern. SIM detection rate was 88.6%-100% in patients with Ⅳ tipe and Ⅴ tipe capillary forms.Nosignificant difference was found betweenthe BE mucosal morphology prediction bied NBI-ME and pathological results （P0.05）.Conclusion NBI-ME can accurately predict BE mucosa with SIM and improve the detection rate of SIM. It has significantclinical application value. 【Key Words】 Barrett’s esophagus；NarrowbandImagingSystemwithMagnifyingEndoscopy； Specialized intestinal metaplasia；Diagnosis Barrett食管（Barre