内镜成像技术在诊断浅表非壶腹部十二指肠上皮肿瘤中的应用进展

Advances in endoscopic imaging techniques for the diagnosis of superficial non-ampullary duodenal epithelial tumors

摘要:

浅表非壶腹部十二指肠上皮肿瘤（SNADET）是指与Vater乳头无关的起源于十二指肠黏膜或黏膜下层的散发性肿瘤。早期SNADET较低的淋巴结转移率使大多数患者适合内镜治疗，但由于十二指肠管腔狭窄、病变形态隐蔽和早期症状缺乏特异性等问题，导致SNADET的漏诊率及误诊率较高，疾病治疗延误，SNADET诊断的准确性、及时性仍亟待提高。目前内镜成像技术从白光内镜等常规技术到色素内镜、共聚焦内镜、细胞内镜、胶囊内镜和AI辅助内镜等新兴技术可以实时提供更高分辨率、多层次的图像，在SNADET的诊断中具有巨大的发展潜力。该文就现有内镜成像技术在SNADET中的研究现状、应用前景作一综述，旨在为提高疾病检出率、诊断一致性提供新的思路与方法。

Abstract:

Superficial non-ampullary duodenal epithelial tumors (SNADETs) are sporadic neoplasms arising from the mucosa or submucosa of the duodenum, independent of the Vater papilla. Early-stage SNADETs are characterized by a low rate of lymph node metastasis, making most cases suitable for endoscopic treatment. However, the narrow duodenal lumen, subtle lesion morphology, and lack of specific early symptoms contribute to high rates of missed diagnosis and misdiagnosis, leading to delayed management. Improving the accuracy and timeliness of SNADET diagnosis remains an urgent clinical need. Endoscopic imaging techniques, ranging from conventional white light endoscopy to chromoendoscopy, confocal laser endomicroscopy, endocytoscopy, capsule endoscopy, and AI-assisted endoscopy, now offer real-time, high-resolution, and multi-layered visualization. These advances provide significant potential for improving the detection and characterization of SNADETs. This review summarizes the current status and clinical applications of existing endoscopic imaging techniques in SNADET diagnosis, aiming to provide new strategies and insights for enhancing lesion detection and diagnostic consistency.