如果是你，先看看这两个食管有没有问题？有问题的地方在哪里？

可能有点难度.....

【CASE4】

Routine observation: A mildly reddish area of about 8 mm was seen (arrows). Given the absence of evident granular changes at the redness, an invasion depth T1a-EP cancer was suspected

白光下可见一约8mm轻度发红的病变，鉴于未见颗粒感改变，故考虑上皮内肿瘤可能性大。

Iodine staining: An area unstained with iodine was observed at the site of the redness seen by routine observation

碘染后病对应区域呈负染区。

NBI: The lesion was visualized as a brownish area (arrows) at the site of the redness detected by routine observation

NBI下观察病变对应区域呈茶褐色。

Magnifying NBI: Type VI vascular pattern was revealed

放大观察可见血管大部呈井上分型的V1型（个人认为也可见V2型）

Pathological findings: Squamous cell carcinoma, 0-IIc, T1a-LPM, ly0, v0, HM0, VM0

病理提示为固有层鳞癌，切缘阴性，淋巴血管阴性。

Diagnostic Points:

Iodine-unstained areas were scattered, but a positive pink color sign was recognized only at this site, which would help lead to the diagnosis.

诊断观察要点：在碘染多发分散的情况下，请注意粉红征的变化。

【CASE5】

Routine observation: The lesion (arrows) was difficult to detect by routine observation

白光观察很难发现的一病变。（0-IIb,5-mm）

Iodine staining: The lesion was seen as an area unstained with iodine and with a positive pink color sign

碘染后呈负染区，粉红征阳性。

NBI: The lesion was visualized as a brownish area (arrows)

Magnifying NBI: Type V1 vascular pattern was revealed

NBI下呈茶褐色改变，放大观察IPCL大部分呈井上分型V1型改变，少量V2。

Pathological findings: Squamous cell carcinoma, 0-IIc, T1a-LPM, ly0, v0, HM0, VM0

病理提示为固有层鳞癌，切缘阴性，淋巴血管阴性。

Diagnostic Points:

The iodine-unstained area with a positive pink color sign and a type V vascular

pattern are suggestive of malignancy.

诊断观察要点：碘染呈负染，粉红征阳性，V型血管均提示肿瘤性病变。

【CASE6】

Routine observation: There was a reddish depression protruding from the squamous-columnar junction (SCJ) to the squamous cell epithelium in the shape of a tongue. Although lower esophageal palisade vessels were unclear, the SCJ appeared irregular; and the presence of short-segment Barrett’s esophagus (SSBE) was suspected

位于SCJ的浅凹陷发红的舌形病变拟为SSBE，表面结构不规则，表面血管不清。

Indigo carmine staining: Depression of the lesion became clearer. There was no surface irregularity at the depression

靛胭脂染色后病变清晰，表面结构基本规则。

Magnifying NBI: Reticular vascular pattern was observed at the depression, strongly suggesting malignancy

Magnifying NBI: A change in mucosal structure at the margin of the depression was revealed, which better demarcated the boundary

网格状血管形态高度提示肿瘤性病变，边界线清晰存在。

Pathohistological findings: Adenocarcinoma (tub 1), M, ly0, v0, HM0, VM0

病理提示粘膜内高分化管状腺癌，切缘阴性，血管淋巴阴性。

Diagnostic Point:

It is necessary to observe carefully the reddish mucosa at the SCJ. In particular, when SSBE is present, detecting a change in mucosal structure and abnormal blood vessels by magnifying NBI would help with the diagnosis.

观察诊断要点：仔细观察SCJ附近的发红区域，当发现 SSBE时，进一步放大观察表面结构及血管形态至关重要。