Advanced endoscopic imaging for Barrett's Esophagus: current options and future directions.
Advanced endoscopic imaging for Barrett's Esophagus: current options and future directions.
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DOI：
10.1007/s11894-012-0259-3
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发表时间：
2012-06-01
影响因子：
--
通讯作者：
Anandasabapathy, Sharmila
中科院分区：
文献类型：
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作者：
Lee, Michelle H;Buterbaugh, Kristin;Anandasabapathy, Sharmila
巴雷特食道是食管腺癌的先兆，食管腺癌是美国增长最快的癌症之一。鉴于晚期腺癌预后较差，建议对Barrett‘s食管病患者进行内窥镜检查，以发现早期肿瘤。目前的指南建议在整个巴雷特节段每隔1-2厘米进行一次“随机”的四象限活检。然而，这只是一小部分上皮细胞的样本，并且已经被证明漏掉了内窥镜下不明显的肿瘤(高度不典型增生或癌)的区域。最近的努力集中在开发新的诊断成像技术，以检测与Barrett‘s食管异型增生和肿瘤相关的细微上皮变化。这些模式中的一些被用作“危险信号”技术，旨在探测大面积表面区域内的异常区域。其他技术用于确定可见异常区域的特征，提供更高的空间分辨率来确认/排除肿瘤的存在。本文综述了几种可用于Barrett相关肿瘤的内窥镜诊断和监测的可用和不断发展的成像技术。
Barrett's esophagus is the precursor to esophageal adenocarcinoma, one of the most rapidly increasing cancers in the United States. Given the poor prognosis of late-stage adenocarcinoma, endoscopic surveillance is recommended for subjects with Barrett's esophagus to detect early neoplasia. Current guidelines recommend "random" four-quadrant biopsies taken every 1-2cm throughout the Barrett's segment. However, this only samples a minority of epithelium and has been shown to miss areas of endoscopically- inapparent neoplasia (high grade dysplasia or cancer). Recent efforts have focused on developing novel diagnostic imaging technologies to detect the subtle epithelial changes associated with dysplasia and neoplasia in Barrett's esophagus. Some of these modalities serve as "red flag" technologies designed to detect areas of abnormality within large surface areas. Other technologies serve to characterize areas of visible abnormality, offering a higher spatial resolution to confirm/exclude the presence of neoplasia. This review summarizes several available and evolving imaging technologies used in the endoscopic diagnosis and surveillance of Barrett's associated neoplasia.