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首页> 外文期刊>Endoscopy International Open >Staging of T1 esophageal adenocarcinoma with volumetric laser endomicroscopy: a feasibility study
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Staging of T1 esophageal adenocarcinoma with volumetric laser endomicroscopy: a feasibility study

机译：T1食管腺癌的分期具有体积激光子宫内膜：可行性研究

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Background and study aims Precise staging in T1 esophageal adenocarcinoma (EAC) is critical in determining candidacy for curative endoscopic resection. High-frequency endoscopic ultrasound (EUS) has demonstrated suboptimal accuracy in T1 EAC staging due to insufficient spatial resolution. Volumetric laser endomicroscopy (VLE) allows for high-resolution wide-field visualization of the esophageal microstructure. We aimed to investigate the role of VLE in staging T1 EAC. Patients and methods Patients undergoing endoscopic mucosal resection (EMR) were prospectively enrolled and only T1 EAC cases were included. EMR specimens were imaged using second-generation VLE immediately after resection. VLE images were analyzed for signal intensity by depth and signal attenuation (dB/mm) in both cross-sectional and en-face orientation. A decision tree model was constructed to combine measured VLE parameters and delineate diagnostic thresholds. Results Thirty EMR scans were obtained – 15 T1a specimens from 9 patients and 15 T1b specimens from 11 patients. T1b specimen VLE scans exhibited higher signal intensity ( P ?0.0001) and higher signal attenuation compared to T1a specimens ( P =?0.03). A combination of signal attenuation and signal intensity at 150?μm depth yielded optimal diagnostic thresholds and an area under the curve (AUC) of 0.77.?VLE signal attenuation was significantly associated with grade of differentiation, irrespective of EAC stage. Conclusions VLE signal intensity and signal attenuation are quantitatively distinct in T1a and T1b EAC and associated with grade of differentiation. This is the first study examining the role of VLE for staging of T1 EAC and demonstrates promising diagnostic performance. With further in vivo validation, VLE may serve a role in staging superficial EAC.
机译：背景和研究旨在在T1食管腺癌（EAC）中的精确分期对于确定治疗内窥镜切除术的候选性至关重要。由于空间分辨率不足，高频内窥镜超声（EUS）在T1 EAC分期中表现出次优精度。体积激光端子显微镜（VLE）允许食管微观结构的高分辨率宽场可视化。我们旨在调查VLE在分期T1 EAC中的作用。患者和方法患者接受内镜粘膜切除（EMR）的患者进行了前瞻性注册，仅包括T1 EAC病例。在切除后立即使用第二代VLE成像EMR标本。通过深度和信号衰减（DB / mm）分析VLE图像，在横截面和面向面向方向上进行信号强度。构建决策树模型以组合测量的VLE参数和描绘诊断阈值。结果获得了30例EMR扫描 - 来自9名患者的15个T1A标本和11名患者的15吨T1B标本。与T1A样本相比，T1B样品VLE扫描表现出更高的信号强度（P <0.0001）和更高的信号衰减（P = 0.03）。信号衰减和信号强度在150Ωμm深度的组合产生最佳诊断阈值和0.77的曲线（AUC）下的区域。随着EAC阶段而言，与分化的等级显着相关。结论VLE信号强度和信号衰减在T1A和T1B EAC中定量不同，与分化等级相关联。这是第一次研究VLE对T1 EAC分期的作用，并展示了有前途的诊断性能。进一步在体内验证中，VLE可以在分期造型EAC中发挥作用。

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