摘要
目的应用色彩增强技术（F1CE）联合内镜观察食管病变后食管上皮乳头内毛细血管袢（IPCL）的改变，探讨FICE在食管病变诊断中的价值。方法对患者先行普通胃镜检查，发现食管病变后再利用富士能EG-590ZW内镜行FICE观察，分析食管病变后食管上皮IPCL改变，并研究了31例浅表性食管病变的IPCL与病理组织学之间关系。结果（1）FICE放大观察将IPCL分为4型：Ⅰ型IPCL分布均匀，形态规则，见于正常食管；Ⅱ型IPCL延长，主要见于食管炎；Ⅲ型IPCL出现扩张、波浪样弯曲、管径粗细不均以及不规则形态改变中的2至3种改变，主要见于食管上皮异型增生；Ⅳ型IPCL出现扩张、波浪样弯曲、管径粗细不均以及不规则形态改变中所有4种变化，主要见于食管鳞癌。（2）17例食管炎中15例IPCL表现为Ⅱ型、2例表现为Ⅲ型；10例食管上皮异型增生中8例IPCL表现为Ⅲ型、2例表现为Ⅳ型，表现为Ⅳ型的2例均为重度食管上皮异型增生；1例sml食管鳞癌IPCL表现为Ⅲ型；3例进展期食管鳞癌均表现为Ⅳ型。结论FICE联合内镜能清楚显示食管黏膜IPCL，通过应用FICE联合内镜观察食管病灶的IPCL变化，可以很好地确定食管浅表性病变的性质，对食管肿瘤性病变的诊断具有重要的应用价值。
Objective To assess the potential diagnostic value of the potential of flexible image col- or enhancement system（FICE） with magnifying endoscopy for superficial esophageal lesions by observing the intrapapillary capillary loops （IPCL） in esophageal mucosa. Methods IPCL in patients with esophageal diseases were studied with Fujinon EG-590ZW FICE endoscopy. The relationship between changes of 1PCL in 31 cases of superficial esophageal lesions and pathological findings was studied. Results The vascular patterns of IPCL were analyzed and classified as follows： Type Ⅰ , often seen in normal esophagus, were evenly distributed with regular forms. Type Ⅱ , protracted, often occured in esophagitis. Type Ⅲ showed two or three of such four changes as, dilatation, wave-like inflection, irregular caliber and deformity, which was mainly seen in dysplasia. While Type IV showed all the four changes mentioned above and frequently appeared in esophageal cancer. Of the 17 cases of esophagitis, fifteen cases were Type Ⅱ IPCL and the others Type Ill. Of the 10 cases of dysplasia, eight were Type Ⅲ IPCL and two high-grade dysplasia showed Type IV IPCL. One sml early esophageal cancer showed Type Ill IPCL and all three advanced esophageal cancer showed Type IV IPCL. Conclusion The esophageal microvessels can be clearly seen by FICE with magnifying endoscopy, and the differentiation of superficial esophageal lesions can be fairly performed with the observation of IPCL, it gives an important practical siginificance in diagnosing tumorous lesions.
出处
《中华消化内镜杂志》
2008年第4期178-181,共4页
Chinese Journal of Digestive Endoscopy
关键词
色彩增强技术
窄带成像技术
上皮乳头内毛细血管袢
Flexible image color enhancement
Narrow-band imaging
Intraepithlial papillary capillary loops
