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目的共聚焦显微内镜(CEM)是将共聚焦显微镜整合于内镜头端的一种新型内镜,可在细胞水平观察活体组织。本研究目的是评价 CEM 在内镜检查的同时对胃凹陷型病变的病理预测价值。方法应用 CEM 对43例患者的51个凹陷型病灶进行检查。将 CEM 诊断与相应部位活检标本的常规病理结果进行前瞻性和双盲对比。结果对每个病灶的边缘和(或)中心的共172个点进行共聚焦扫描,获得4872幅共聚焦图像。CEM 可以获得活体的胃黏膜表面和表面下清晰的细胞和胃小凹结构的荧光图像。CEM 对胃癌诊断的敏感度、特异度和准确度分别为95.7%、97.6%、97.1%。结论 CEM 可以在内镜检查的同时对胃癌组织做出准确度很高的虚拟病理学检查,对于胃凹陷型病变的鉴别诊断及胃癌的早期诊断具有较高的应用价值。
Objective Confocal microscopic endoscopy (CEM) is a new type of endoscope that integrates a confocal microscope with the endoscope to observe the living tissue at the cellular level. The aim of this study was to evaluate the pathological predictive value of CEM in endodermal lesions with endoscopic examination. Methods 51 depressed lesions in 43 patients were examined by CEM. Prospective and double-blind comparison of routine pathological results of CEM diagnosis and corresponding biopsy specimens. Results Confocal scanning was performed on a total of 172 points at the edge and / or center of each lesion to obtain 4,872 confocal images. CEM is capable of obtaining fluorescent images of living gastric mucosal surfaces and subepithelial clear cells and pits. The sensitivity, specificity and accuracy of CEM in the diagnosis of gastric cancer were 95.7%, 97.6% and 97.1%, respectively. Conclusion CEM can detect the virtual histopathological examination of gastric cancer with high accuracy at the same time of endoscopy. It is of high value in the differential diagnosis of gastric recessive lesions and in the early diagnosis of gastric cancer.