Characterization and identification of gastric hyperplastic polyps and adenomas by confocal laser endomicroscopy
Characterization and identification of gastric hyperplastic polyps and adenomas by confocal laser endomicroscopy
复制标题
共聚焦激光内窥镜对胃增生性息肉和腺瘤的表征和鉴定
DOI：
10.1007/s00464-009-0608-y
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发表时间：
2010-03-01
影响因子：
3.1
通讯作者：
Li, Yan-Qing
中科院分区：
文献类型：
--
作者：
Li, Wen-Bo;Zuo, Xiu-Li;Li, Yan-Qing
胃息肉的治疗取决于其组织学组成。实时的活体组织学诊断对“桌上”的管理决策是有价值的。激光共聚焦内窥镜(CLE)是一种新的诊断工具，可以对胃肠道病变进行实时在体组织学评估。本研究旨在评价激光共聚焦超声诊断和鉴别诊断胃增生性息肉和胃腺瘤的可行性和实用性。研究对象为2007年1月至2008年8月在山东大学齐鲁医院就诊的66例息肉患者，中国。对增生性息肉和胃腺瘤进行了CLE成像，并与组织病理学诊断的金标准进行了比较，成功地对60个胃增生性息肉和27个胃腺瘤病变进行了CLE成像。胃增生性息肉和胃腺瘤与周围背景粘膜相比，CLE表现明显。胃增生性息肉和胃腺瘤的活体CLE诊断的总准确率为90%(95%可信区间，83-96%)，而胃增生性息肉和腺瘤的整体CLE鉴别准确率为97%(95%可信区间，90-99%)。观察者间一致性良好(kappa=0.92；95%CI，0.82-0.99)，观察者间一致性也很好(kappa=0.83，95%CI，0.70-0.96)。本研究描述了胃增生性息肉和腺瘤的共聚焦图像以及CLE对增生性息肉和腺瘤的高准确度区分。
Management of gastric polyps depends on their histologic composition. A real-time in vivo histologic diagnosis would be valuable to an "on table" management decision. Confocal laser endomicroscopy (CLE), a new diagnostic tool, allows real-time in vivo histologic evaluations of gastrointestinal lesions. This study aimed to assess the feasibility and practicability of using CLE to identify and differentiate gastric hyperplastic polyps and adenomas.A total of 66 patients with previously diagnosed polyps were recruited for this study between January 2007 and August 2008 at Qilu Hospital, Shandong University, China. The CLE imaging of hyperplastic polyps and adenomas was performed, and the CLE diagnosis was compared with the gold standard of histopathologic diagnosis.Imaging by CLE was successfully performed for 60 lesions of gastric hyperplastic polyps and 27 lesions of gastric adenomas. Compared with the surrounding background mucosa, gastric hyperplastic polyps and adenomas showed typical distinct appearances, respectively, by CLE. The overall accuracy of the in vivo CLE diagnosis of gastric hyperplastic polyps and adenomas during ongoing endoscopy was 90% (95% confidence interval [CI], 83-96%), and the overall accuracy of differentiating gastric hyperplastic polyps and adenomas by CLE was 97% (95% CI, 90-99%) after endoscopy. Intraobserver agreement was perfect (kappa = 0.92; 95% CI, 0.82-0.99), and interobserver agreement was also good (kappa = 0.83, 95% CI, 0.70-0.96).This study characterized confocal images of gastric hyperplastic polyps and adenomas as well as the high accuracy of differentiating hyperplastic polyps and adenomas using CLE.