Endoscopic detection of early upper GI cancers.
Endoscopic detection of early upper GI cancers.
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DOI：
10.1016/j.bpg.2005.04.006
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发表时间：
2005-12-01
期刊：
影响因子：
--
通讯作者：
Wilson, Brian C
中科院分区：
文献类型：
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作者：
Wong Kee Song, Louis-Michel;Wilson, Brian C
上消化道早期肿瘤性病变的检测与生存率的提高和完全内镜切除的可能性相关，内镜切除是微创的，比手术发病率低。尽管标准白光内窥镜技术进步，内窥镜医师可靠检测上消化道发育异常和早期癌变的能力仍然有限。在Barrett食管等情况下，实践指南建议定期进行内镜监测和多次活检，这种方法受到随机抽样错误，组织病理学解释不一致和诊断延迟的阻碍。早期检测可以通过几种有前途的诊断方式来增强，如色素内镜、放大内镜和光学光谱/成像技术，因为这些方式提供了在常规内镜下实时识别不明显病变的潜力。新的诊断技术和局部内镜治疗的结合将为内镜医师提供急需的工具，可以大大提高上消化道早期病变的检测和管理。
The detection of early-stage neoplastic lesions in the upper GI tract is associated with improved survival and the potential for complete endoscopic resection that is minimally invasive and less morbid than surgery. Despite technological advances in standard white-light endoscopy, the ability of the endoscopist to reliably detect dysplastic and early cancerous changes in the upper GI tract remains limited. In conditions such as Barrett's oesophagus, practice guidelines recommend periodic endoscopic surveillance with multiple biopsies, a methodology that is hindered by random sampling error, inconsistent histopathological interpretation, and delay in diagnosis. Early detection may be enhanced by several promising diagnostic modalities such as chromoendoscopy, magnification endoscopy, and optical spectroscopic/imaging techniques, as these modalities offer the potential to identify in real-time lesions that are inconspicuous under conventional endoscopy. The combination of novel diagnostic techniques and local endoscopic therapies will provide the endoscopist with much needed tools that can considerably enhance the detection and management of early stage lesions in the upper GI tract.