窄带成像放大内镜靶向活检在胃黏膜肠上皮化生中的临床运用  

The clinical application of magnifying endoscopy with narrow-band imaging(ME-NBI) in targeted-biopsy of intestinal metaplasla

作　　者：邱全兴[1] 汤瑜[1] 胡学军[1] 姚平[1] 

机构地区：[1]南京中医药大学江阴附属医院消化内科,江苏江阴214400

出　　处：《安徽医药》2015年第2期344-346,共3页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨窄带成像放大内镜(magnifying endoscopy with narrow-band imaging NBI-ME)下胃黏膜肠上皮化生(intestinal metaplasia IM)的形态学特征,并结合病理学探讨NBI-ME下靶向活检诊断IM的临床运用。方法对50例患者行常规检查,窄带成像放大内镜(NBI-ME)观察胃体有无浅蓝色的嵴状结构(light blue crest LBC)、边缘透光带(marginal turbid band MTB)区域,分别在LBC、MTB区域或阴性区域活检,并对病理结果进行比较分析。结果 50例患者中,共获得112块活检组织,其中88块组织取自MTB+区域,其中病理学诊断IM:68例,灵敏度:97.1%,特异度:52.3%;24块组织取自LBC+区域,其中病理学诊断IM:22例,灵敏度:31.4%,特异度:95.2%;MTB+/LBC+区域重度IM比例最高.NBI-ME下在LBC、MTB阳性黏膜区活检可明显提高IM的检出率(P<O.05)。结论 NBI-ME对MTB、LBC区域靶向活检,提高IM的检出率,对胃癌的早期发现、早期诊断、早期治疗有重要的意义。Objective To investigate the morphologic features of gastric intestinal metaplasia （IM） using magnifying endoscopy with narrow-band imaging（ ME-NBI） and its clinical use in the diagnosis of IM under ME-NBI targeted biopsy.Methods The endoscopic examination was performed on 50 patients and suspected lesions of gastric body associated with IM were further observed by ME-NBI. The biopsy specimens were obtained from regions containing light blue crest （ LBC） ,marginal turbid band （ MTB ） mucosa or normal area for pathological examination, and the results were analyzed.Results In 50 patients examined with ME-NBI, we received 112 pieces of biopsy samples.IM was pathologically confirmed in patients.For the diagnosis of IM,MTB had a sensitivity and specificity of 97.1%and 52.3%,respectively,and the corresponding values for LBC were 31.4%and 95.2%.When groups classified according to the presence or absence of MTB and LBC were compared,severe IM was more commonly seen in MTB＋/LBC＋areas than in the other two regions.Conclusion It has been demonstrated that NBI–ME can improve the diagnosis of IM by targeted-biopsy in LBC or MTB region,which is helpful in early diagnosis of gastric cancer.

关 键 词：窄带成像 胃黏膜 肠上皮化生 

分 类 号：R573[医药卫生—消化系统]