放大色素内镜结合窄带成像技术对早期胃癌诊断的临床价值研究  

Evaluation of magnification chromoendoscopy combined with narrow-band imaging for diagnosis of neoplasia lesions of early gastric cancer

作　　者：滕春雨[1] 孙咏红[1] 陈浮 王宇[1] 朱海杭 

机构地区：[1]大连市友谊医院消化内科,116000 [2]扬州市苏北人民医院消化内科

出　　处：《中华消化内镜杂志》2015年第8期553-557,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨放大色素内镜结合窄带成像技术对可疑早期胃癌的临床诊断价值。方法选取2010年1月至2012年12月期间进行治疗的115例普通内镜观察下发现可疑早期胃癌病变患者，依次采用放大内镜、放大内镜结合窄带成像技术（ME—NBI）、放大色素内镜、放大色素内镜结合窄带成像技术，记录病变轮廓清晰度、黏膜腺管开1：3形态清晰度、微血管结构形态清晰度评分，并比较腺管开口分型和微血管形态分型。于病变改变最显著部位取活检行病理组织学检查，统计各方法对癌前病变诊断的准确率、灵敏度和特异度。结果放大色素内镜结合窄带成像技术病变轮廓和黏膜腺管开口清晰度评分为377分和458分，优于ME—NBI（340分和408分）和放大色素内镜（354分和386分）（P〈0．05），更优于放大内镜（276分和280分）（P〈0．01）；放大色素内镜结合窄带成像技术病变微血管结构形态清晰度评分为380分，优于ME—NBI（348分）（P〈0．05），更优于放大内镜（267分）和放大色素内镜（280分）（P〈0．01）。放大色素内镜结合窄带成像技术对绒毛状（C型）的检出率亦优于放大色素内镜（93．0％比79．7％，P〈0．05）。放大色素内镜结合窄带成像技术对癌前病变诊断准确率为92．17％、灵敏度为88．33％、特异度为96．36％。结论放大色素内镜结合窄带成像能更清晰地观察到病变轮廓、黏膜腺管开口形态和微血管结构形态，明显提高病变的检出率，便于发现早期瘤变，值得进一步临床观察和推广。Objective To explore the clinical diagnostic value of narrow-band imaging combined with magnification chromoendoscopy for suspicious neoplasia lesions of early gastric cancer. Methods A to- tal of 115 patients which had been diagnosed as having suspicious lesions by conventional endoscopy were en- rolled from Jan. 2010 to Dec. 2012. They were observed by magnifying endoscopy（ C-WLI）, magnifying en- doscopy combined with narrow-band imaging （ME-NBI） , magnification chromoendoscopy and magnification chromoendoscopy combined with narrow-band imaging, respectively. The lesion outline sharpness, opening of the gland sharpness and microvascular morphology sharpness were recorded and the subtypes of opening of the gland and microvaseular morphology were compared. The histological examination was performed on the most significant changes in lesion site and the accuracy, sensitivity and specificity of the four procedures were calculated. Results The score of outline sharpness was 377 and the score of pit sharpness was 458 by mag- nification chromoendoscopy combined with narrow-band imaging, higher than those of ME-NBI （340 and 408 respectively） and magnification chromoendoscopy （354 and 386 respectively） （ P 〈 0. 05 ）, significantly higher than those of C-WLI （276 and 280 respectively） （P 〈 O. 01 ）. The score of microvascular morphology sharpness was 380 by magnification chromoendoscopy combined with narrow-band imaging, higher than that of ME-NBI （ 348, P 〈 0. 05 ）, C-WLI （267, P 〈 0. 01 ） and magnification chromoendoscopy （ 280, P 〈 0. 01 ）.The detection rate of C type by magnification chromoendoscopy combined with narrow-band imaging was high- er than that by magnification chromoendoscopy （93.0% VS 79. 7%, P 〈 0. 05 ）. The accuracy, sensitivity and specificity of magnification chromoendoscopy combined with narrow-band imaging was 92. 17%, 88. 33% ,96. 36% respectively. Conclusion Narrow-band imaging endoscopy combined with pigment am- plification can yield more cl

关 键 词：癌前病变 诊断 内镜窄带成像术 放大内镜检查 

分 类 号：R735.2[医药卫生—肿瘤]