Digital chrome endoscopy and confocal laser endomicroscopy in diagnosis of Barrett esophagus

Abstract

Objective To evaluate digital chrome endoscopy （I-Scan） and confocal laser endomieroscopy （CLE） for diagnosis of Barrett esophagus （BE）. Methods From July 2010 to July 2011, a total of 878 outpatients who had upper gastrointestinal symptoms underwent routine endoscopy and I-Scan examination, screened patients with suspected Barrett＇s epithelial were further referred to CLE and endoscopy. The detection rate and image features of BE between routine endoscopy and I-Scan, and the diagnosis of BE be- tween pathology and CLE, were compared respectively. Results Suspected BE was diagnosed in 46 patients （5.2%） by routine endoscopy, and in 52 （5.9%） by I-Scan, and there was no significant difference in detection rate between 2 methods （X2 = 0. 533, P 〉 0. 05 ）. The detection rate of paliform blood vessels between SCJ and GEJ was higher using I-Scan （35/52, 67.3% ） than routine endoscope （21/46, 45.7% , P 〈0. 05）. A total of 19 suspected BE underwent CLE and biopsy, and BE was diagnosed by CLE with a sensitivity of 93% and a specificity of 100%. Conclusion I-Scan is capable of identifying paliform blood vessels between SCJ and GEJ, and can improve the detection rate of suspected BE. CLE is able to provide in-vivo histological diagnosis of BE with a high sensitivity and specificity. Key words: Barrett esophagus ; Diagnosis ; I-Scan; Confocal laser endomicroscopy