High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett's esophagus: a prospective randomized crossover study
High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett's esophagus: a prospective randomized crossover study
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DOI：
10.1055/s-2005-870433
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发表时间：
2005-10-01
期刊：
影响因子：
9.3
通讯作者：
Bergman, JJGHM
中科院分区：
文献类型：
--
作者：
Kara, MA;Peters, FP;Bergman, JJGHM
背景和研究目的：高分辨率内镜（HRE）可以提高Barrett食管早期肿瘤的检出率。靛蓝胭脂红色素内镜（ICc）和窄带成像（NBI）可能是补充HRE的有用技术。本研究的目的是比较HRE-ICC与HRE-NBI的高度异型增生或早期癌症（HGD/EC）的患者Barrett's esophageal.Patients和方法的检测：28例Barrett's esophageal进行了HRE-ICC和HRE-NBI（分开6 - 8周）在一个随机序列。这两个程序是由两个不同的内窥镜，谁是盲的其他检查的结果。从所有检测到的病变进行靶向活检，然后以2 cm的间隔进行四象限活检。活检评估由一个单一的专家病理学家，谁是盲目的成像techniques used.Results：14例患者被诊断为HGD/EC的监督。HRE-ICC和HRE-NBI对HGD/EC的敏感性分别为93%和86%。单纯HRE靶向活检的敏感性为79%。仅1例患者通过随机活检确诊HGD。ICC和NBI检测到数量有限的额外病变隐匿HRE，但这些病变并没有改变识别HGD/EC.Conclusions患者的敏感性：在大多数患者的高度异型增生或早期癌症在巴雷特食管，微妙的病变可以确定与高分辨率内窥镜。靛蓝胭脂红色素内镜和窄带成像与高分辨率内镜的对比度相当。
Background and study aims: High-resolution endoscopy (HRE) may improve the detection of early neoplasia in Barrett's esophagus. Indigo carmine chromoendoscopy (ICc) and narrow-band imaging (NBI) may be useful techniques to complement HRE. The aim of this study was to compare HRE-ICC with HrE-NBI for the detection of high-grade dysplasia or early cancer (HGD/EC) in patients with Barrett's esophagus.Patients and Methods: Twenty-eight patients with Barrett's esophagus underwent HRE-ICC and HRE-NBI (separated by 6 - 8 weeks) in a randomized sequence. The two procedures were performed by two different endoscopists, who were blinded to the findings of the other examination. Targeted biopsies were taken from all detected lesions, followed by four-quadrant biopsies at 2-cm intervals. Biopsy evaluation was supervised by a single expert pathologist, who was blinded to the imaging technique used.Results: Fourteen patients were diagnosed with HGD/EC. The sensitivity for HGD/EC was 93% and 86% for HRE-ICC and HRE-NBI, respectively. Targeted biopsies had a sensitivity of 79% with HRE alone. HGD was diagnosed from random biopsies alone in only one patient. ICC and NBI detected a limited number of additional lesions occult to HRE, but these lesions did not alter the sensitivity for identifying patients with HGD/EC.Conclusions: In most patients with high-grade dysplasia or early cancer in Barrett's esophagus, subtle lesions can be identified with high-resolution endoscopy. Indigo carmine chromoendoscopy and narrow-band imaging are comparable as adjuncts to high-resolution endoscopy.