Use of volumetric laser endomicroscopy for dysplasia detection at the gastroesophageal junction and gastric cardia

• 作者: Ann Koons Christopher Chapman Irving Waxman John Hart Namrata Setia Nina Gupta Shu-Yuan Xiao Uzma Siddiqui Vani Konda Vesta Valuckaite
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: 容量的激光 endomicroscopy 贲门 Gastroesophageal 连接 Barretts 光连贯断层摄影术 瘤形成
• 年，卷（期）: 2017,（7）
• 页码范围: 319-326
• 页数: 8页
• 分类号: R735

摘要

AIM To determine specific volumetric laser endomicroscopy(VLE) imaging features associated with neoplasia at the gastroesophageal junction(GEJ) and gastric cardia.METHODS During esophagogastroduodenoscopy for patients with known or suspected Barrett’s esophagus,VLE was performed before biopsies were taken at endoscopists’ discretion.The gastric cardia was examined on VLE scan from the GEJ(marked by top of gastric folds) to 1 cm distal from the GEJ.The NineP oints VLE console was used to analyze scan segments for characteristics previously found to correlate with normal or abnormal mucosa.Glands were counted individually.Imaging features identified on VLE scan were correlated with biopsy results from the GEJ and cardia region.RESULTS This study included 34 cases.Features characteristic of the gastric cardia(gastric rugae,gastric pit architecture,poor penetration) were observed in all(100%) scans.Loss of classic gastric pit architecture was common and there was no difference between those with neoplasia and without(100% vs 74%,P = NS).The abnormal VLE feature of irregular surface was more often seen in patients with neoplasia than those without(100% vs 18%,P < 0.0001),as was heterogeneous scattering(86% vs 41%,P < 0.005) and presence of anomalous glands(100% vs 59%,P < 0.05).The number of anomalous glands did not differ between individual histologic subgroups(ANOVA,P = NS).CONCLUSION The transition from esophagus to gastric cardia is reliably identified on VLE.Histologically abnormal cardia mucosa produces abnormal VLE features.Optical coherence tomography algorithms can be expanded for use at the GEJ/cardia.