放大内镜结合窄带成像对胃黏膜不典型增生检出率的影响  

Clinical application value of magnifying endoscopy combined with narrow band imaging for the detection of gastric mucosal atypical hyperplasia

作　　者：赖四海[1,2] 吴建维[1,2] 陈小燕[1,2] 邹伟清[1,2] 林丽嫚[1,2] 

机构地区：[1]深圳市第八人民医院 [2]南方医科大学附属深圳宝安医院消化内科,广东深圳518101

出　　处：《中华肿瘤防治杂志》2015年第16期1257-1260,共4页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的探讨放大内镜（magnifyingendoscopy，ME）结合窄带成像（narrowbandimaging，NBI）技术对提高胃黏膜不典型增生检出的临床价值。方法选取2011一01—01—2013—12—31深圳市第八人民医院行普通白光内镜（whitelightendoscopy，WLE）检查发现胃黏膜形态、色泽异常的患者284例作为研究对象，分为观察组和对照组，每组142例。观察组，男91例，女51例，年龄24~77岁，行放大内镜结合窄带成像（magnifyingendoscopywithnarrowbandimaging，ME_NBI）对胃黏膜进行靶向活组织检查，对照组，男92例，女50例，年龄25～77岁，WLE直视下于病变部位取多点活组织检查，对两组检出病变情况比较分析。病理检查结果为轻、中和重不典型增生病变或瘤变，视为阳性结果。结果对照组发现阳性病例共81例，总检出率为57．04％。其中轻度不典型增生59例，栓出率为41．54％；中度21例，检出率为14．78％；重度1例，检出率为0．70％。观察组发现阳性病例122例，总检出率为85．91％。其中轻度62例，检出率为43．66％；中度50例，检出率为35．21％；重度10例，检出率为7．04％。10例重度不典型增生中，1例行内镜黏膜下剥离术（endoscopicsubmucosaldissection，ESD）后病理确诊为早期胃癌（earlygastriccarcinoma，EGC）。两组数据对比，总检出率及中、重度检出率差异有统计学意义，P〈0．01；而轻度不典型增生检出率差异无统计学意义，P〉0．05。结论ME—NBI技术对胃黏膜微小病变的观察优于普通白光内镜，在ME-NBI指导下的靶向活组织检查可提高不典型增生的检出率。OBJECTIVE To explore the application value of magnifying endoscopy（ME） combined with narrow band imaging（NBI） for the detection of gastric mucosal atypical hyperplasia. METHODS Totally 284 cases abnormal shape, colour and luster of gastric mucosa were detected by white light endoscopy（WLE）, which were divided into two groups with the method of random digits table, 142 cases in each group. The gastric mucosal lesions in the control group were located by WLE and then performed for biopsy. The gastric mucosal lesions in the observation group were located by magnifying endoscopy with narrow band imaging（ME-NBI） technology, and the biopsies in the lesion targets of gastric pits and microvessels were examined. The pathological examination results with mild, moderate and severe atypical hy- perplasia and lesions were considered as positive results. The two groups were statistically analyzed. RESULTS In the control group, there were 81 positive patients, the total detection rate was 57.04 ~ ,including 59 cases of mild atypical hyperplasia （41.54 ~）, 21 cases of moderate （14.78 ~）, 1 cases of severe （0.70 %）. In the observation group, there were 122 positive patients, the total detection rate was 85.91~, including 62 cases of mild atypical hyperplasia （43.66%）, 50 cases of moderate （35.21%）, 10 cases of severe （7.04 %）. One case was diagnosed as early gastric cancer（EGC） after endoscopic submucosal dissection（ESD）. There was significant difference in the total detection rates and detection rates of moderate and severe between the control group and the observation group （P〈0.01）. There was not significant differ- ence in the detection rates of severe atypical hyperplasia between them （P〉0.05）. CONCLUSIONS ME-NBI technology is better than WLE in the observation of small gastric mucosal lesion. ME-NBI can improve biopsy accuracy and detection rate.

关 键 词：早期胃癌 放大内镜 窄带成像 不典型增生 

分 类 号：R735.2[医药卫生—肿瘤]