Surveillance of patients with Barrett's esophagus for dysplasia and cancer with balloon cytology
Surveillance of patients with Barrett's esophagus for dysplasia and cancer with balloon cytology
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DOI：
10.1053/gast.1997.v112.pm9178668
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发表时间：
1997-06-01
期刊：
影响因子：
29.4
通讯作者：
Richter, JE
中科院分区：
文献类型：
--
作者：
Falk, GW;Chittajallu, R;Richter, JE
背景与目的：Barrett‘s食管癌监测方法成本较低，本研究的目的是比较非内窥镜气囊细胞学检查与活检和刷检细胞学在Barrett’s食管癌和异型增生中的诊断价值。方法：监测项目中的患者在胃镜活检和刷检前行气囊细胞学检查，细胞学结果与组织学结果进行比较。结果：63例气囊细胞学检查患者中52例(83%)和61例刷检细胞学检查患者中59例(97%)获得了足够的柱状上皮细胞，8例腺癌患者中6例球囊细胞学检查获得异常细胞，2例高度不典型增生和癌患者中2例获得异常细胞。8例低度异型增生中2例，气囊细胞学对高度异型增生或癌的敏感性为80%，而对低度异型增生的敏感性仅为25%，无异型增生或癌患者无异常细胞。9例低度异型增生中仅2例有细胞学异常(敏感性，22%)，39例无异型增生患者中有2例有细胞异常(特异度95%)，气囊细胞学检查费用比胃镜活检费用低6倍。结论：球囊细胞学检查在采样充分的情况下可检出80%的高度异型增生或癌患者，刷状细胞学数据提示移动研磨气囊可提高气囊细胞学的敏感性，气囊细胞学检查与Barrett‘s食道癌的内窥镜肿瘤监测相比节省了潜在的成本支持这项技术的进一步研究。
Background & Aims: A less costly cancer surveillance method for Barrett's esophagus is desirable, The aim of this study was to compare nonendoscopic balloon cytology with biopsy and brush cytology for detecting dysplasia and carcinoma in patients with Barrett's esophagus, Methods: Patients in a surveillance program underwent balloon cytology before endoscopy with biopsy and brush cytology, Results of cytology were compared with those of histology, Results: Adequate columnar epithelium was obtained in 52 of 63 (83%) patients with balloon cytology and 59 of 61 (97%) with brush cytology, Balloon cytology obtained abnormal cells in 6 of 8 patients with adenocarcinoma, 2 of 2 patients with high-grade dysplasia, and 2 of 8 patients with low-grade dysplasia, Sensitivity of balloon cytology for high-grade dysplasia or carcinoma was 80% but only 25% for low-grade dysplasia, No patients without dysplasia or carcinoma had abnormal cells. Brush cytology was abnormal in all 11 patients with high-grade dysplasia or carcinoma but only 2 of 9 patients with low-grade dysplasia (sensitivity, 22%), Two of 39 patients without dysplasia had abnormal cells (specificity, 95%), Balloon cytology cost was sixfold less than endoscopy with biopsy, Conclusions: Balloon cytology detected 80% of patients with high-grade dysplasia or carcinoma when sampling was adequate, Brush cytology data suggest that a move abrasive balloon may improve balloon cytology sensitivity, The potential cost savings of balloon cytology compared with endoscopic cancer surveillance in Barrett's esophagus support further studies of this technique.