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Objective To investigate the value of high resolution microendoscopy ( HRME ) for assessment of mucosal healing in patients with ulcerative colitis ( UC ) during clinical remission. Methods A total of 30 UC patients were randomly selected to collect HRME images. Pathological results were used as the gold standard to establish the diagnostic criteria of HRME on evaluation of colonic mucosal status. And then a prospective study was performed on 67 patients, who underwent standard endoscopy to evaluate colonic mucosal status and obtain biopsy specimens. The specimens were collected for HRME imaging. The accuracy of standard endoscopy and HRME in assessing ulcerative colonic mucosal healing was compared. Results According to the gland morphology, gland arrangement, gland opening and inflammatory cell infiltration, the HRME criteria for assessing UC mucosal status were formulated and divided into 0-3 grades with 4 levels. The prospective study of 67 patients with 113 sites showed that the sensitivity, specificity, positive predictive value, and negative predictive value of standard endoscopy for assessing mucosal healing in UC patients were 44. 68％ ( 21/47 ) , 90. 91％ ( 60/66 ) , 77. 78％ ( 21/27 ) , and 69. 77％ ( 60/86 ) , respectively, and the corresponding indicators of HRME imaging was 87. 23％ (41/47), 95. 45％ (63/66), 93. 18％ (41/44), and 91. 30％ (63/69), respectively. Compared with pathological results, the Kappa value of the consistency test of standard endoscopy and HRME imaging were 0. 379 and 0. 835, respectively ( both P<0. 05) . Conclusion HRME can achieve real-time virtual pathological imaging of colonic mucosa for UC patients, which is more accurate than standard endoscopy for assessing mucosal healing.
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Objective To summarize the picture features of high resolution micro-endoscopy (HRME) for normal gastrointestinal mucosa. Methods We select 10 cases' normal esophageal mucosa, gastric and duodenal mucosa, in-testinal mucosa and colonic mucosal biopsies for this study, use HRME to observe the specimens and describe the features of different parts of the digestive tract normal mucosa according to the collected HRME pictures. Results After HRME imaging, all specimens were sent to pathological examination. We obtained 1 284 HRME pictures for 50 cases of biopsy specimens, 400 pictures were selected for results analysis after screening. HRME image charac-teristics of different parts of the digestive tract normal mucosa are as follows. Esophageal mucosa: cell arrangement rules, round and bright nucleus, the same size, nuclear spacing normal, the number of cells per field in basically are the same. Fundic mucosa: numerous closely arranged glands as well as oval or elongated branched openings of the gastric pits and linear peripheral cracks were visible; the nuclei were arranged regularly. Antral mucosa: irregular or tubular openings of the gastric pits and cracked glandular cavities were visible, with the cells surrounding the gastric pits regularly arranged and the nuclei small and densely distributed. Duodenal mucosa:visible villi was large fingers,on both sides of lint jagged depression, stereoscopic obviously, a cluster-like arrangement and the gap was crack-like. Intestinal mucosa:villous structures wider gap is wider, less than the number of the duodenum. Colonic mucosa:the nucleus of the same size, shape rules, round or oval and daisy-like glandular structures. All specimens were confirmed normal mucosa by pathology. Conclusion HRME can accurately identify the different parts of the diges-tive tract normal mucosa and it has a high consistency compared with pathological results.
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Objective To explore the feasibility of high?resolution micro?endoscopy for diagnosis of gastric cancer. Methods A retrospective analysis of HRME pictures of gross specimen of gastric carcinoma of 20 cases of gastric cancer and normal gastric mucosa was made. Picture characteristics were studied and the HRME diagnostic criteria for normal gastric mucosa and gastric cancer tissues were developed. Based on the diagnostic criteria, a prospective study on gastric biopsy specimens of 64 cases of suspected gastric carci?noma was conducted and the diagnostic value of HRME for gastric carcinoma was evaluated by comparing HRME pre?diagnostic results with pathological findings. Results In the superficial layer of the fundic muco?sa, numerous regularly branched arranged glands as well as oval or elongated openings of the gastric pits and linear peripheral cracks were visible;the nuclei were arranged regularly. In the superficial layer of the antral mucosa, irregular or tubular openings of the gastric pits and cracked glandular cavities were visible, with the cells surrounding the gastric pits regularly arranged and the nuclei small and densely distributed. In the gas?tric carcinoma, nuclei sizes were different, arranged messy. Gland sizes were various, with unclear structure or glandular structures that could not be observed. Structure of gastric pits was damaged and normal gastric pits disappeared. After HRME imaging was performed on 64 cases of gastric biopsy specimens, the sensitivi?ty, specificity, accuracy, negative predictive value and positive predictive value of HRME diagnosis of gastric carcinoma were 96?4%( 53/55 ) , 88?9%( 8/9 ) , 95?3%( 61/64 ) , 98?1%( 53/54 ) and 80?0%( 8/10) respectively. Conclusion HRME, a new and instant pathological imaging tool with low price and simple operation, can distinguish normal gastric mucosa and gastric cancer tissue clearly, with a high diagno?sis value for gastric cancer.
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Objective To investigate the therapeutic value of high-resolution microendoscopy for early esophageal cancer.Methods A total of 60 patients,who underwent esophageal endoscopy,were included in this study.The therapeutic value of high-resolution microendoscopy was investigated with reference to pathological results as golden standard.Results Diagnostic sensitivity,specificity,positive predictive value,negative predictive value and accuracy of microendoscopy for high grade dysplasia/early cancer were 81.22％,94.12％,81.82％,94.12％,91.11％,respectively.Diagnosis of severe dysplasia/carcinoma with high-resolution microendoscopy was highly consistent with that of pathology (K =0.760).Conclusion The high-resolution microendoscopy is of high diagnostic value for early esophagus cancer.