Morphological characteristics of Barrett's esophagus under confocal laser endomicroscopy / 中华消化杂志

ABSTRACT

Objective To explore the morphological characteristics of Barrett's esophagus under confocal laser endomicroscopy (CLE).Methods A total of 112 patients with suspected Barrett's esophagus (BE) under endoscopy were enrolled in this study.The lower esophageal columnar mucosa was examined with CLE to real-time forecast the histological type and extent of intestinal metaplasia of BE,followed by mucosal biopsies and histopathological examination in inspected area.The relationship between the features under common endoscopy or CLE and histopathological diagnosis was analyzed.Results A total of 94 patients were diagnosed as BE.Island type is the most common type under common endoscopy (54.3％),and the incidence of short-segment BE was higher than that of longsegment BE (86.2 ％ vs 13.8 ％).Specialized intestinal metaplasia,cardiac and fundic epithelium can be distinguished under CLE,and the accuracy was 94.7％,89.4％ and 91.5％ respectively.The histopathological examination in targeted biopsy specimens indicated that the proportion of intestinal metaplasia was higher in long-segment BE (9/13) than that of short-segment BE (33.3 ％,x2 =4.684,P=0.039),and the proportion of intestinal metaplasia was higher in circumferential(11/17) and tongue-like BE (65.4％) than that of island type (15.7％,x2 =15.217 and 19.399 respectively,P＜0.01).There were no significant difference in the extent of intestinal metaplasia among island type,circumferential type and tongue-like type in short-segment and long-segment BE.Conclusions The histological type of BE can be accurately distinguished with CLE.The most common type of BE is island type.The incidence of intestinal metaplasia is higher in circumferential and tongue-like type.The incidence of intestinal metaplasia is higher in long-segment BE than that of short-segment BE.