Multispectral scanning during endoscopy guides biopsy of dysplasia in Barrett's esophagus.
Multispectral scanning during endoscopy guides biopsy of dysplasia in Barrett's esophagus.
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在美国，食管癌的发病率比其他任何癌症都要高。巴雷特食管是食管反流的一种良性并发症，影响了大约300万美国人，并且几乎先于所有食管癌病例。如果检测为高度异型增生（HGD），大多数食管癌是可以预防的。异型增生的标准护理筛查使用目视内窥镜和规定的活检模式。这种方法只选择一小部分受影响的组织进行病理学检查，检测的可能性很低，因为发育异常是高度集中的，视觉上无法区分。我们开发了一种称为内窥镜偏振扫描光谱（EPSS）的系统，该系统可对整个食管表面进行快速光学扫描和多光谱成像，并在接近真实的时间内提供诊断。通过检测和绘制可疑部位，对不可见的癌前病变进行引导活检变得可行。在这里，我们报告了EPSS的发展及其在几个临床病例中的应用，其中一个值得特别考虑。
Esophageal cancer is increasing in frequency in the United States faster than any other cancer. Barrett’s esophagus, an otherwise benign complication of esophageal reflux, affects approximately three million Americans and precedes almost all cases of esophageal cancer. If detected as high-grade dysplasia (HGD), most esophageal cancers can be prevented. Standard-of-care screening for dysplasia uses visual endoscopy and a prescribed pattern of biopsy. This procedure, in which a tiny fraction of the affected tissue is selected for pathological examination, has a low probability of detection because dysplasia is highly focal and visually indistinguishable. We developed a system called endoscopic polarized scanning spectroscopy (EPSS), which performs rapid optical scanning and multispectral imaging of the entire esophageal surface and provides diagnoses in near real time. By detecting and mapping suspicious sites, guided biopsy of invisible, precancerous dysplasia becomes practicable. Here we report the development of EPSS and its application in several clinical cases, one of which merits special consideration.
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