窄带成像与放大染色技术在诊断胃癌及癌前病变中的对比研究  

A comparative study of narrow-band imaging and chromoendoscopy in the diagnosis of gastric cancer and lesion precancerous

作　　者：瞿春莹[1] 周敏[1] 徐雷鸣[1] 张毅[1] 陈莺[1] 陈惠芳[1] 

机构地区：[1]上海交通大学附属新华医院消化内镜诊治部,200092

出　　处：《中华临床医师杂志（电子版）》2009年第5期22-25,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的应用窄带成像技术(NBI)和放大染色技术对胃可疑病变处进行观察,比较两种技术在诊断胃癌及癌前病变中的差异。方法选取2008年10月至12月进行放大胃镜检查患者中胃小凹分型为Ⅲ型以上的40例患者作为研究对象,对可疑病变处依次进行放大胃镜、NBI放大胃镜和放大染色胃镜观察,对三者图像的清晰度、胃小凹分型评价情况以及胃癌和癌前病变诊断情况进行比较。结果在这40例患者中,NBI放大胃镜下观察病变清晰度明显高于放大胃镜下和放大染色胃镜下(P<0.05);NBI放大胃镜与放大染色胃镜在胃小凹分型的评价方面,差异无统计学意义(P>0.05);NBI放大胃镜对胃癌及癌前病变诊断的准确性、敏感性、特异性与放大染色胃镜比较,差异无统计学意义(P>0.05)。结论NBI通过对胃小凹形态改变的观察,从而发现可疑病变,精确引导活检,有助于提高胃癌及癌前病变的检出率。Objective To compare the diagnostic efficacies of narrow-band imaging （NBI） and chromoendoscopy in gastric cancer and lesion precancerous. Methods From October to December in 2008, we selected 40 patients who accepted NBI endoscopy and whose pit patterns were diagnosed above pit Ⅲ by magnifying endoscopy as objects of research. We used magnifying endoscopy followed by NBI, then chromoendoscopy （indigocarmine）combined magnifying endoscopy sequentially in suspicious lesions, and compared the quality of images with different endoscopic methods, the evaluation of five pit patterns were captured by two techniques involving, the diagnosis of gastric cancer and lesion precancerous. Results Among these patients, the the quality of images in NBI was the best （ P 〈 0.05 ） ; the evaluation of five pit patterns were different insignificantly between these two techniques（P 〉 0. 05 ） ;the accuracy, sensibility and specificity of diagnosis in gastric cancer and lesion precancerous all have insignificant deviation（ P 〉 0. 05 ）. Conclusions As a novel endoscopic system, NBI finds suspicious lesions easily by observing pit pattern, in order to biopsy exactly ,then help to raise the detection rates of gastric cancer and lesion precancerous.

关 键 词：胃肿瘤 癌前状态 胃窥镜检查 诊断显像 染色与标记 

分 类 号：R735.2[医药卫生—肿瘤] R446[医药卫生—临床医学]