Читать книгу Gastrointestinal Pathology - Группа авторов - Страница 10

Herbert C. Wolfen1, Michael B. Wallace1, Naohisa Yahaghi2 and Yutaka Saito3

1 Mayo Clinic, Jacksonville, Florida, USA

2 Keio University Cancer Center, Tokyo, Japan

3 National Cancer Center, Tokyo Japan

Tissue sampling of the gastrointestinal tract at the time of endoscopy is the cornerstone of many gastrointestinal diagnoses. The development of a flexible endoscope and the subsequent ability to directly acquire tissue under optical guidance has been one of the most important advancements in the field of gastroenterology throughout its history. Although tissue sampling can be performed through nonendoscopic devices, the ability to directly correlate precise locations and target biopsies to specific areas of disease is critical to our ability to diagnose and further understand gastrointestinal pathology. Many of the advancements in our understanding of the basic pathology and molecular biology of gastrointestinal disease can be directly attributed to our ability to acquire tissue for histological, molecular, and genetic analyses. An excellent example is our deep understanding of the molecular pathology of colorectal cancer development from normal colonic epithelium to adenoma to colorectal cancer, a discovery made possible because of colonoscopic access to precursor lesions such as adenomatous polyps and early cancers.

In this chapter, we will review general principles of tissue acquisition at the time of endoscopy including the following topics:

 Endoscopic equipment for obtaining tissue including endoscopic accessory channels, biopsy forceps, snare devices, needle aspiration and cytology brush.

 General principles of optimal sampling technique.

 Methods of tissue preparation in the endoscopy laboratory to optimize diagnostic accuracy.

 The role of endoscopic ultrasound (EUS)‐guided fine‐needle aspiration cytology.