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改进巴雷特食管症检测的采样设备

By LabMedica International staff writers
Posted on 22 Apr 2018
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WATS3D活检是钳活检的辅助手段,它发现了一名食管异常的患者(图片蒙CDx Diagnostics公司惠赐)。
WATS3D活检是钳活检的辅助手段,它发现了一名食管异常的患者(图片蒙CDx Diagnostics公司惠赐)。
食管腺癌是美国最致命、增长最快的癌症之一,如果能在癌变前检测到,则可以预防。患巴雷特食管症时,食道鳞状粘膜被化生性柱状粘膜取代,后者容易发展成食管腺癌(EAC)。
 
肠胃病医师每年对慢性烧心及巴雷特食管症患者进行逾五百万例上内窥镜检查,以期在癌前细胞进展成癌症之前发现它们。虽然我们还不能在内窥镜检前准确预测哪些病人有巴雷特食管症,但是我们已知男性得巴雷特食管症比女性更常见。
 
美国纽约州罗彻斯特大学医学中心(www.urmc.rochester.edu)的科学家进行了一项多中心前瞻性实验,招募了4,203名患者,有些是因疑似巴雷特食管症而接受筛查的患者,有些是已知的巴雷特食管症患者,他们在全美25家社区级肠胃病中心接受观察。因为四象限随机钳夹活检(FB)会导致采样误差,所以筛查与监控性质的食管镜检经常漏检巴雷特食管症与食管不典型增生(ED)。
 
科学家采用美国纽约州萨芬市CDx Diagnostics公司(www.cdxdiagnostics.com)的带三维组织分析的广域经上皮采样(WATS3D),成功地从更大的食道表面上快速采集到一份样本。WATS3D采样面积更大,采用三维成像技术,再由专家进行细胞病理分析,对于保护病人健康具有深远意义。现在很容易检测到癌前细胞,并在癌变前摘除或杀灭之,有效遏制食道癌。
 
该研究的论文首发于2017年11月28日的《欧盟肠胃病杂志》(United European Gastroenterology Journal)。作者报道,4,203名患者中,单用钳夹活检诊断出594人有巴雷特食管症,加上WATS又检测到493例病例,巴雷特食管症的总体检测率提高了83% (493/594, 95% CI 74%–93%)。 单用钳夹活检诊断出26名患者有轻度不典型增生(LGD),加上WATS又检测到23例病例,使LGD的检测率提高了88.5% (23/26, 95% CI 48%–160%)。参与研究的绝大多数是胃食管反流病(GERD)患者,他们没有巴雷特食管症史,研究中诊断出的巴雷特食管症的平均长度小于1.5厘米,这也许会降低内窥镜检诊断的准确度。
 
论文的领衔作者、肠胃病医师Seth Gross大夫说:“此前的临床实验显示,WATS3D活检极大提高了巴雷特食管症的检测率以及胃食管反流病患者食道组织癌前变化的检测率,我们的数据证实了上述发现。最终,WATS3D这项革命性的技术有望使食道癌变得可预防。”2018年1月,WATS3D研究也作为ASGE的Scope Tech讲坛视频的一部分受到重点推介,发送给15,000名成员。
 
Related Links:

罗彻斯特大学医学中心>>> www.urmc.rochester.edu

CDx Diagnostics >>> www.cdxdiagnostics.com



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