Cv 260sl

The entire esophagus and stomach were examined by esophagogastroduodenoscopy, including careful examinations of the cardia, especially focused on the high GCA incidence anatomical site located at the right anterior side of the esophagogastric junction (EGJ) from the axial view at endoscopy (34 ), according to a standardized protocol devised for the trial. The EGJ was recognized as the most proximal extent of the gastric fold at endoscopy. The cardia region was defined as the area 20 mm to the EGJ at endoscopy. During careful examinations of the stomach cardia and non-cardia (including the fundus, corpus, antrum, pylorus, and angle), suspicious lesions showing congestion, bleeding, roughness, erosion, plaque, or nodularity were targeted, and biopsies were taken. The number of biopsies taken was dependent on the size of the lesions (1~3 biopsies for each lesion). All endoscopic examinations were conducted in the local Cancer Institute/Hospital of Linzhou and were performed by board-certified endoscopists trained by the Cancer Institute/Cancer Hospital, Chinese Academy of Medical Sciences. Two endoscopists, blinded to the results of the questionnaire and ¹³C-UBT assay, performed the procedures. All endoscopic examinations were performed using the same type of endoscope (Olympus CV-260SL, Japan).

Two experienced operators performed the EGD using the equipment (Olympus CV-260SL, Japan). The variance was described according to the expert guidelines [24 (link)]. EUS was conducted by skilled professional doctors using the equipment (Olympus GF-UE260, Japan). According to the results of gastroscopy and endoscopic ultrasonography, the patients were divided into three groups: no gastroesophageal varices (negative on EUS and EGD); early gastroesophageal varices (positive on EUS and negative for EGD), and positive on EUS and EGD. In this study, we mainly focused on comparing the first two groups.

We performed bronchoscopy (OLYMPUS, CV-260SL) for each patient, and six tissue biopsies were taken from two separate locations: 3 from anthracotic plaques (Group A) and three from seemingly intact tissues at the periphery of the lesions (Group B). They were put into two separate solutions containing formalin denomination and randomly labeled samples as groups 1 and 2. The samples underwent fixation, embedding, sectioning, and staining with hematoxylin and eosin. Then, they were given to an independent pathologist for evaluation who was not aware of randomization. Samples were also sent to the clinical laboratory to test tuberculosis according to the standard operating procedures for Mycobacterium tuberculosis (M. tb) detection. Furthermore, bronchoalveolar lavage (BAL) fluid from involved bronchi was collected for cytology study and M. tb smear and culture.

Bronchoscopy was performed according to the summary of the British Thoracic Society guidelines for diagnostic flexible bronchoscopy in adults in 2013 (11 (link)). The bronchoscope used was an Olympus CV-260SL model that can enter the main, segmental, and subsegmental bronchus. If a new lesion or blockage was observed during bronchoscopy, we flushed the visible findings and recovered the fluid, and defined it as BFF. If no visible findings were observed during bronchoscopy, we performed bronchoalveolar lavage and recovered the fluid, and defined it as BALF. The flushing operation and bronchoalveolar lavage were performed as follows.
We injected 40 mL of 37°C sterilized normal saline into the new lesion (BFF) or the lung segment of the suspected lesion (BALF). Immediately, we used negative pressure to recover the lavage solution, lavage three times, and ensured that the total amount of recovered BFF/BALF was not less than 50 mL. Half of the BFF/BALF was used for cytological diagnosis, while the other half was used for gene methylation detection.