食管鳞状细胞癌高分辨率显微内镜图像定量分析的诊断价值  

Quantitative analysis of high resolution microendoscopic images for diagnosis of esophageal squamous cell carcinoma

作　　者：贾逸文 屈亚威[2] 刘海峰[1,2] 

机构地区：[1]安徽医科大学研究生院,合肥230032 [2]武警总医院消化内科,北京100039

出　　处：《武警医学》2017年第3期268-272,275,共6页Medical Journal of the Chinese People's Armed Police Force

基　　金：基金项目:首都临床特色应用研究(Z141107002514099)

摘　　要：目的探究食管鳞状细胞癌高分辨率显微内镜图像定量分析的诊断价值。方法选择35例食管鳞状细胞癌和正常食管黏膜的大体标本,在前期制定的食管鳞状细胞癌高分辨率显微内镜(high resolution microendoscopy,HRME)诊断标准的基础上,回顾性分析其HRME图像特征。根据标本病理结果,由一名经验丰富的HRME医师挑选出1张HRME图片,纳入训练集,用计算机软件对图像特征进行定量分析,制定图像分析诊断标准。在此基础上,将100例内镜下疑诊食管鳞状细胞癌的活检标本的HRME图像纳入测试集,进行HRME图像定量分析,将计算机分析得出的预诊断结果与病理结果进行比较,评估定量分析HRME图像对食管鳞状细胞癌的诊断价值。结果通过定量分析HRME图像中细胞的核面积(nuclear area,NA)对食管鳞状细胞癌和正常食管黏膜进行区分,经统计学分析,在训练集中的敏感性和特异性分别为90%和97%,测试集中的敏感性和特异性分别为97%和90%。结论定量分析HRME图像可以区分食管鳞状细胞癌组织和正常食管黏膜,并能够增加诊断的客观性,有利于HRME技术的推广应用。Objective To explore the diagnostic value of high-resolution microendoscopy in quantitative analysis of esophageal squamous cell carcinoma. Methods Thirty-five cases of esophageal squamous cell carcinoma and normal esophageal mucosa were selected. The HRME image of esophageal squamous cell carcinoma was analyzed retrospectively. According to the pathological results of specimens, an HRME image was selected by an experienced HRME clinician to be included in the training set. The image features were quantitatively analyzed by computer software, and diagnostic criteria for image analysis were formulated. On this basis, the HRME images of biopsy specimens of 100 cases of suspected esophageal squamous cell carcinoma were input into the test set for quantitative a- nalysis of these HRME images. The results of pre-diagnosis via a computer were compared with pathological resuhs. The diagnostic value of quantitative HRME images for esophageal squamous cell carcinoma was determined. Results The quantitative analysis of the nuclear area in HRME images was used to distinguish esophageal squamous cell carcinoma from normal esophageal mucosa. Statistical analysis showed that the sensitivity and specificity were 90% and 97% respectively in the training set, but were 97% and 90% respectively in the test set. Conclusions Quantitative analysis of HRME images can distinguish esophageal squamous cell carcinoma from normal esophageal mueosa, increase the reliability of diagnosis, and contribute to the popularization and application of this technology.

关 键 词：高分辨率显微内镜 食管癌 定量分析 诊断 

分 类 号：R604[医药卫生—外科学] R735.1[医药卫生—临床医学]