早期胃癌nbi放大内镜诊断应用ppt课件.ppt

WLE 气体量 胃底胃体上部 判断过浅 胃窦 判断过深 * ME-NBI用于EGC的浸润深度预测 ME-NBI在判断胃癌浸润深度方面存在争议，胃癌的组织多样性和炎症背景为主要原因 无MS结构、散在分布的血管、微血管扭曲或扩张对于病灶浸润深度的判断具有一定的指导意义？ * MS：destroyed, obscure, irregular MV：thickened, irregular shape, asymmetrically distributed. M癌 * MS：absent surface pattern MV：sparse, isolated, heterogeneous microvessels; and avascular areas sm1癌 * 组织学分型 * WLE用于EGC的组织学分型凹陷型病变 分化型 未分化型 颜色 发红 褐色 凹陷面性状 平滑-凹凸不平、不规则胃小区形状 无结构-凹凸不平、岛状黏膜残存 凹陷深度 浅 深 边缘性状 较为平坦 界限明显，呈断崖状 背景黏膜 萎缩、肠化 非萎缩 皱襞先端所见 逐渐变细或增粗 突然变细、消失 * ME-NBI用于EGC的组织学分型 MV的结构表现分为三大类 A型，精细网络，fine network；--分化型 B型，螺旋型，corkscrew； ---未分化型 C型，未定型，unclassified） 表面微结构缺失表型（Absent microsurface pattern，AMSP）是未分化腺癌的一个指征 * 精细网络---分化型 * 螺旋型—未分化型 * 谢谢 * a C-WLI ?ndings.his lesion (arrow) was classi?ed as not red colored (pale) using C-WLI. b Magnifying endoscopy with narrow-band imaging (M-NBI) ?ndings (arrows, DL). Using the vessel plus surface (VS) classi?cation system, this lesion was diagnosed as cancer by the presence of an irregular MV pattern plus an irregular MS pattern. c The histopathological diagnosis of the resected specimen was EC. * A representative case of low-grade adenoma (LGA). a C-WLI ?ndings. This lesion (arrow) was classi?ed as not red colored (pale) using C-WLI. b M-NBI ?ndings (arrows, DL). Using the vessel plus surface (VS) classi?cation system, this lesion was diagnosed as noncancer by the presence of a regular MV pattern plus a regular MS pattern, with a DL. c The histopathological diagnosis of the resected specimen was LGA * Gastrointest Endosc. 2014 Jan;79(1):55-63. doi: 10.1016/j.gie.2013.07.008. Epub 2013 Aug 7. An efficient diagnostic strategy for small, depressed early gastric cancer with magnifying narrow-band imaging: a post-hoc analysis of a prospective randomized controlled trial. * Endoscopy.?2004 Dec;36(12):1080-4. Magnifying?endoscopy?combined?with?narrow?band?imaging?system?for?early?gastric?cancer:correlation?of?vascular?pattern?with?histopathology?(including?video). * Endoscopy.?2004 Dec