Magnifying endoscopy for the diagnosis of specialized intestinal metaplasia in short-segment Barrett's esophagus

作     者：Nam Seok Ham Jae Young Jang Sung Woo Ryu Ji Hye Kim Eui Ju Park Woong Cheul Lee Kwang Yeun Shim Soung Won Jeong Hyun Gun Kim Tae Hee Lee Sung Ran Jeon Jun Hyung Cho Joo Young Cho So Young Jin Ji Sung Lee 

作者机构：Institution for Digestive ResearchDigestive Disease CenterDepartment of Internal MedicineSoonchunhyang University HospitalSeoul 140-743South Korea Department of PathologySoonchunhyang University HospitalSeoul 140-743South Korea Biostatistical Consulting UnitSoonchunhyang University HospitalSeoul 140-743South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第41期

页      面：7089-7096页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100214[医学-肿瘤学] 10[医学] 

主　　题：Short-segment Barrett’s esophagus Magnifying endoscopy Methylene blue chromoendoscopy Specialized intestinal metaplasia Dysplasia Esophageal adenocarcinoma Diagnosis 

摘      要：AIM:To determine whether magnified observation of short-segment Barrett’s esophagus(BE)is useful for the detection of specialized intestinal metaplasia(SIM).METHODS:Thirty patients with suspected short-segment BE underwent magnifying endoscopy up to×*** magnified images were analyzed with respect to their pit-patterns,which were simultaneously classified into five epithelial types[Ⅰ(small round),Ⅱ(straight),Ⅲ(long oval),Ⅳ(tubular),Ⅴ(villous)]by Endo’s ***,a 0.5%solution of methylene blue(MB)was sprayed over columnar *** patterns of the magnified image and MB staining were *** were obtained from the regions previously observed by magnifying endoscopy and MB ***:Three of five patients with a typeⅤ(villous)epithelial pattern had SIM,whereas 21 patients with a non-typeⅤepithelial patterns did not have *** sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of pit-patterns in detecting SIM were 100%,91.3%,92.3%,60%and100%,respectively(P=0.004).Three of the 12 patients with positive MB staining had SIM,whereas 14patients with negative MB staining did not have *** sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MB staining in detecting SIM were 100%,60.9%,65.4%,25%and100%,respectively(P=0.085).The specificity and accuracy of pit-pattern evaluation were significantly superior compared with MB staining for detecting SIM by comparison with the exact McNemar’s test(P=0.0391).CONCLUSION:The magnified observation of a shortsegment BE according to the mucosal pattern and its classification can be predictive of SIM.