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目的探讨增强放大内镜对 Barrett 食管的诊断价值。方法对40例疑诊为 Barrett 食管的患者使用2%～3%乙酸喷洒于食管下端,然后使用放大内镜观察并根据黏膜象进行活检。所有活检切片均由高年资病理专家在单盲情况下进行阅片。结果参考2003年 Toyoda 在增强放大内镜下的分型黏膜象共有3型:Ⅰ型小圆型7例(17.5%),其中5例病理为胃底型(71.4%);Ⅱ型网格型24例(60.0%),其中16例病理为胃底型(66.7%);Ⅲ型脑回/绒毛型9例(22.5%),病理均为肠上皮化生或异型增生。Ⅲ型黏膜象与病理的符合率高。结论使用增强放大内镜对食管远端进行详细黏膜象观察与病理检查结果有较高符合率,有助于对 Barrett 食管肠上皮化生和异型增生的诊断。
Objective To explore the value of enhanced magnifying endoscopy in the diagnosis of Barrett’s esophagus. Methods 40 patients suspected of Barrett ’s esophagus were treated with 2% -3% acetic acid and sprayed on the lower esophagus. Then they were magnified endoscopy and biopsy was performed according to the mucosal image. All biopsy sections were read by high-grade pathologists under single-blind conditions. Results According to Toyoda’s magnifying endoscopy in 2003, there were 3 types of mucosal lesions: 7 cases (17.5%) with type I small round, of which 5 cases had gastric fundus (71.4%); Type II 24 cases (60.0%), of which 16 cases of gastric fundus (66.7%); Ⅲ type of gyrus / villi in 9 cases (22.5%), pathological intestinal metaplasia or dysplasia. Ⅲ type mucosal and pathological coincidence rate. Conclusions It is helpful to diagnose Barrett’s esophageal intestinal metaplasia and dysplasia by using enhanced magnifying endoscopy to observe the detailed mucosal appearance and pathology results of distal esophageal.