窄带成像放大内镜诊断胃黏膜上皮内瘤变的临床价值  

The value of magnifying endoscopy with narrow-band imaging in diagnosis of gastric mucosal intraepithelial neoplasia

作　　者：曾海龙[1] 张正坤[1] 田君才[1] 戴伟平[1] 夏铭[1] 王伟[1] 姚建华[1] 

机构地区：[1]酒泉市人民医院消化科,甘肃735000

出　　处：《中国临床新医学》2016年第12期1116-1119,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨窄带成像放大内镜（NBI-ME）诊断胃黏膜上皮内瘤变的临床应用价值。方法选择2013-04-2015-08行普通白光胃镜（WLE）检查发现局灶性病变且自愿接受NIB-ME检查的100例患者作为研究对象,行NBI-ME检查观察病变的胃黏膜、毛细血管形态,并分别依据Sakami分型标准以及Yao分类标准对胃黏膜及毛细血管形态进行判断,之后对病变进行活检,将NBI-ME观察到的胃黏膜以及毛细血管形态分型与病理结果进行比较。结果经内镜检查显示,100例局灶性病变最终病理组织学证实炎症31例（31.0%）,低级别上皮内瘤变44例（44.0%）,高级别上皮内瘤变25例（25.0%）,其中早期胃癌18例（18.0%）。WLE诊断上皮内瘤变的灵敏度、特异度、阳性预测值、阴性预测值、符合率分别为58.7%、35.3%、62.7%、29.3%、49.0%;NBI-ME诊断上皮内瘤变的灵敏度、特异度、阳性预测值、阴性预测值、符合率分别为84.4%、43.5%、83.3%、45.5%、75.0%,NBI-ME诊断胃黏膜上皮内瘤变的符合率明显高于WLE（75.0%vs49.0%,P〈0.05）。结论 NBI-ME在胃黏膜上皮内瘤变的诊断中具有较高的临床价值。Objective To study the clinical application value of narrow-band imaging magnifying endoscopy（ NBI-ME） in the diagnosis of gastric mucosal intraepithelial neoplasia. Methods One hundred patients with focal lesions examined by white light endoscopy（ WLE） were selected in this study,and NIB-ME check was used to observe the pathological changes of gastric mucosa and capillaries,and then the morphologies of gastric mucosa and capillaries were observed respectively on the basis of Sakami classification criteria and Yao. The biopsy of the lesions was performed and the results were compared with the pathological results. Results In 100 focal lesions examined by endoscopy inflammation was histopathologically,confirmed in 31 cases（ 31. 0%）,low level intraepithelial neoplasia in44 cases（ 44. 0%）,and high level intraepithelial neoplasia in 25 cases（ 25. 0%）,and 18 cases with early gastric cancer（ 18. 0%）. The sensitivity,specificity,positive predictive value,negative predictive value and coincidence rate of in diagnosing intraepithelial neoplasia were 58. 7%,35. 3%,62. 7%,29. 3% and 49. 0% respectively; The sensitivity,specificity intraepithelial neoplasia,and positive predictive value,negative predictive value and coincidence rate of NBI- ME in diagnosing intraepithelial neoplasia were 84. 4%,43. 5%,83. 3%,45. 5% and 75. 0%respectively. The accuracy of NBI-ME in diagnosing the early gastric cancer was significantly higher than that of WLE（ 75. 0% vs 49. 0%,P〈0. 05）. Conclusion Magnifying endoscopy with narrow-band imaging has a high clinical application value in the diagnosis of gastric mucosal intraepithelial neoplasia.

关 键 词：窄带成像 放大内镜 胃癌 

分 类 号：R735[医药卫生—肿瘤]