Confocal laser endomicroscopy in Barrett's esophagus and endoscopically inapparent Barrett's neoplasia: a prospective, randomized, double-blind, controlled, crossover trial.
Confocal laser endomicroscopy in Barrett's esophagus and endoscopically inapparent Barrett's neoplasia: a prospective, randomized, double-blind, controlled, crossover trial.
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DOI：
10.1016/j.gie.2009.02.009
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发表时间：
2009-10
影响因子：
7.7
通讯作者：
Canto, Marcia Irene
中科院分区：
文献类型：
--
作者：
Dunbar, Kerry B.;Okolo, Patrick, III;Montgomery, Elizabeth;Canto, Marcia Irene
巴雷特食管（BE）的高度发育不良和癌症的检测是具有挑战性的。共聚焦激光内镜（CLE）允许在内镜检查中观察粘膜组织学。与标准内窥镜下4象限随机活检（SE-RB）方案相比，确定CLE联合光学活检和靶向粘膜活检（CLE- tb）是否能提高内窥镜下隐性be相关肿瘤的诊出率。随机交叉研究单一三级医疗学术中心BE患者接受常规监测或非局部内镜下不明显BE相关肿瘤的治疗所有参与者都随机接受了共聚焦内镜下靶向活检和标准内镜下四象限活检。增加肿瘤的诊断率，减少粘膜活检次数，最终病理诊断。CLE结合靶向活检几乎使肿瘤的诊断率提高了一倍，与最终诊断肿瘤的标准方案相当。监测组2/3的患者根本不需要任何粘膜活检。与标准内窥镜随机活检方案相比，单中心研究CLE结合靶向活检显著提高了内窥镜下隐性BE瘤变的诊出率。CLE结合靶向活检也大大减少了每位患者所需的活检次数，并允许一些无瘤变的患者完全放弃粘膜活检。
The detection of high grade dysplasia and cancer in Barrett’s esophagus (BE) can be challenging. Confocal laser endomicroscopy (CLE) allows in vivo visualization of mucosal histology during endoscopy. To determine if CLE with optical biopsy and targeted mucosal biopsy (CLE-TB) improves the diagnostic yield of endoscopically inapparent BE-associated neoplasia compared to standard endoscopy with a 4-quadrant random biopsy (SE-RB) protocol Prospective, double-blind, randomized crossover study Single tertiary care academic center Patients with BE undergoing routine surveillance or non-localized endoscopically inapparent BE-associated neoplasia referred for treatment All participants underwent both a confocal endomicroscopy with targeted biopsy procedure and standard endoscopy with 4-quadrant biopsy procedure in a randomized order. Increase in diagnostic yield for neoplasia, reduction in mucosal biopsy number, final pathologic diagnosis. CLE with targeted biopsy almost doubled the diagnostic yield for neoplasia and was equivalent to the standard protocol for the final diagnosis of neoplasia. 2/3 of patients in the surveillance group did not need any mucosal biopsies at all. Single center study CLE with targeted biopsy significantly improves the diagnostic yield for endoscopically inapparent BE neoplasia compared to a standard endoscopy with random biopsy protocol. CLE with targeted biopsy also greatly reduces the number of biopsies needed per patient and allows some patients without neoplasia to completely forgo mucosal biopsy.
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影响因子：
29.4
作者：
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影响因子：
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