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目的观察Barrett食管在共聚焦激光显微内镜下的形态学特征,评价共聚焦激光显微内镜对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,即共聚焦激光显微内镜诊断。最后对扫描部位黏膜活检,将共聚焦激光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个部位进行共聚焦激光显微内镜扫描,结果显示共聚焦激光显微内镜诊断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%。结论共聚焦激光显微内镜可以在内镜检查同时快速准确的诊断Barrett食管。
Objective To observe the morphology of Barrett ’s esophagus under confocal laser photomicroscopy and evaluate the diagnostic value of confocal laser microscopy to Barrett’ s esophagus. Methods Patients with suspected Barrett’s esophagus underwent gastroscopy were selected for confocal laser scanning microscopy. Confocal or diseased parts of the confocal endoscopy scan, immediately after the prediction of histological diagnosis, confocal laser microscopic endoscopy diagnosis. Finally, the mucosal biopsy of the scanning site, confocal laser microendoscopic diagnosis and pathological diagnosis were compared. Results Confocal laser scanning endomicroscopy was performed on 73 sites of 23 selected patients. The results showed that the sensitivity, specificity and accuracy of confocal laser micro-endoscopy in diagnosing Barrett’s esophagus were 95.6%, 96.4% and 97.7% respectively %, The negative predictive value was 93.1%, the diagnostic coincidence rate was 95.9%. Conclusion Confocal laser microendoscopy can diagnose Barrett ’s esophagus rapidly and accurately during endoscopy.