The Diagonostic Value Of High-reolution Microendoscopy In The Early Esophageal Carcinoma

Background:Esophageal cancer is one of the world's common digestive tract cancer, the significant regional difference that is the main epidemiological features. Digestive endoscopy examination is the primary means for early diagnosis the esophageal cancer and precancerous lesions. Endoscopy often missed some early neoplastic lesions. With the continuous progressive of new endoscopic, people has become increasingly concerned about the small lesions in the mucosa.Because for the doctors it is not difficult to find a large progressive lesion, the key is how to detect the early of small, atypical Lesions, this is a important challenge. Most of Chinese esophageal cancer are in advanced, the prognosis are poor, so the increasing rate of early diagnosis of esophageal cancer is the urgent task. Early esophageal cancer can be treated by endoscopic local resection and avoid major surgery. High-resolution microendoscopy is emerging as a low cost, relatively simple imaging technology. It is important to provide real-time imaging, particularly it also can provide an objective diagnostic indicators, such as the nuclear and cytoplasm ratio, etc, eliminating the subjective errors. The discovery of early esophageal cancer has important diagnostic value. In this study, we using the high-resolution microendoscopy to detect the early esophageal cancer and found the effectiveness in early diagnosis of esophageal cancer with the high-resolution microendoscopy.Objective:The aim of this study is to assess the diagonostic value of high-resolution microendoscopy in diagnosis of the early esophageal cancer.Method:In the experiment, the patients had the esophagus symptoms, with Luge solution staining the esophageal mucosa, the stained area did not exist or light colored. During the examination, the high-resolution endoscopy images of 90 sites were analysised by the two operations physicians.Then compared the outcome with the pathology. Results:Examine the 90 sites with the high-resoulution microendoscopy, we obtained 412 videos, including 22 sites detected as high grade dysplasia/carcinoma by high-resoulution microendoscopy, confirmed by pathology 18 sites as high grade dysplasia/cancer. The microendoscopy diagnose as high grade dysplasia/cancer,it's diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 81.22%, 94.12%,81.82%,94.12%,91.11%. It was consistent highly with pathology on severe dysplasia/carcinoma.Conclusion:The high-resolution microendoscopy in the diagnosis of early cancer have a higher consistency with pathology. In clinical, high- resolution microendoscopy has a huge advantage. in early detection and diagnose.