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首页> 美国卫生研究院文献>Endoscopy International Open >Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors
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Diagnostic utility of probe-based confocal laser endomicroscopy in superficial non-ampullary duodenal epithelial tumors

机译：基于探针的共聚焦激光内镜在浅表非壶腹十二指肠上皮肿瘤中的诊断价值

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>Background and study aims  Endoscopic diagnosis of superficial non-ampullary duodenal epithelial tumors (SNADETs) has not been established. Probe-based confocal laser endomicroscopy (pCLE: Cellvizio) provides real-time endomicroscopic analysis. We developed and validated a new pCLE classification of SNADET based on abnormal findings. >Patients and methods  pCLE scanning of 20 SNADET lesions including 16 adenomas and four carcinomas was retrospectively evaluated to explore abnormal pCLE findings in relation to histological features. Diagnostic yield of pCLE findings was prospectively evaluated in an additional 20 SNADET lesions including 16 adenomas and four carcinomas. >Results  In a retrospective study, we identified four abnormal pCLE findings of SNADETs: (1) dark epithelium, (2) columnar cells irregularly extending to the lumen, (3) distorted crypt structure, and (4) fluorescein leakage. Dark epithelium distinguished neoplastic lesions (adenomas and carcinomas) from non-neoplastic duodenal mucosa with a sensitivity of 90 % and a specificity of 100 %. Distorted crypt structure distinguished carcinomas from adenomas and non-neoplastic duodenal mucosa with a sensitivity of 100% and a specificity of 94 %. In the prospective study, the sensitivity and the specificity of the dark epithelium for the diagnosis of neoplastic lesions (adenomas + carcinomas) was 75% and 100 %. Sensitivity and the specificity of the distorted crypt structure for discrimination of carcinoma from adenoma were 100 % and 94 %, respectively. >Conclusions  The pCLE findings correlated with the histopathology of the SNADETs. Dark epithelium and distorted crypt structure were informative pCLE findings to predict presence of neoplasia and cancer in the SNADET, respectively. UMIN-CTR UMIN000013857 TRIAL REGISTRATION: Single-Center, prospective observational trial UMIN000013857 at
机译：>背景和研究目的尚未建立内镜诊断浅表非壶腹十二指肠上皮肿瘤（SNADET）。基于探针的共聚焦激光内窥镜检查（pCLE：Cellvizio）可提供实时内窥镜分析。我们根据异常发现开发并验证了SNADET的新pCLE分类。 >患者和方法回顾性分析了20例SNADET病变（包括16例腺瘤和4例癌）的pCLE扫描，以探讨与组织学特征相关的异常pCLE发现。前瞻性评估了另外20个SNADET病变（包括16个腺瘤和4个癌）中pCLE诊断结果的诊断价值。 >结果在一项回顾性研究中，我们发现了SNADET的四个异常pCLE发现：（1）深色上皮，（2）柱状细胞不规则地延伸到管腔，（3）隐窝结构扭曲和（4）荧光素泄漏。深色上皮区分非肿瘤性十二指肠粘膜的肿瘤性病变（腺瘤和癌），敏感性为90％，特异度为100％。隐窝结构变形使癌与腺瘤和非肿瘤性十二指肠粘膜区分开来，敏感性为100％，特异性为94％。在前瞻性研究中，深色上皮对肿瘤性病变（腺瘤++癌）的诊断敏感性和特异性分别为75％和100％。隐窝结构变形对区分腺瘤的敏感性和特异性分别为100 were％和94％。 >结论 pCLE结果与SNADET的组织病理学相关。深色上皮和隐窝结构变形是有意义的pCLE发现，可分别预测SNADET的瘤形成和癌变。 UMIN-CTR UMIN000013857试用注册：单中心，前瞻性观察性试验UMIN000013857，于

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