放大NBI内镜在早期胃癌诊断中的应用体会  

Application of narrow band imaging endoscopy in the diagnosis of early gastric cancer

作　　者：叶春荣[1] 付肖岩[1] 黄恒青[1] 

机构地区：[1]福建中医药大学附属第二人民医院脾胃科,福州市350003

出　　处：《临床合理用药杂志》2017年第34期10-12,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的通过对比分析放大NBI内镜(ME-NBI)与普通白光内镜(WLE)诊断早期胃癌的准确性,评价其鉴别可疑病变的价值。方法回顾性分析行WLE或ME-NBI内镜检查发现胃部异常病灶患者218例,根据内镜类型不同将患者分为观察组110例和对照组108例。观察组行ME-NBI检查,对照组行WLE检查,2组病变均进行组织活检或内镜下切除标本病理学检查。对比2组内镜下诊断与病理诊断的情况,计算内镜诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性。结果对照组患者WLE内镜下诊断癌性病变80例,经最终"金标准"病理诊断证实其中癌变10例,非癌变70例;WLE内镜下诊断非癌性病变28例,经最终"金标准"病理诊断证实均为非癌变。观察组患者ME-NBI内镜下诊断癌性病变14例,经最终"金标准"病理诊断证实其中癌变13例,非癌变1例;ME-NBI内镜下诊断非癌性病变96例,经最终"金标准"病理诊断证实其中非癌变94例,癌变2例。对照组108例患者中,病理诊断证实非癌性病变为98例,癌性病变10例。观察组110例患者中病理诊断证实非癌性病变95例,癌性病变15例。观察组诊断EGC的特异性、阳性预测值及准确性明显高于对照组,差异均有统计学意义(P<0.05)。结论早期胃癌的筛查首选WLE,对于WLE发现的疑似病灶进一步行ME-NBI检查并在ME-NBI指引下靶向活检有助于进一步提高诊断率。Objective To compare the diagnosis accuracy of NBI endoscopy （ME-NBI） and white light endoscopy （WLE） in the diagnosis of early gastric cancer, and to valuate its value in identification of suspicious lesions. Methods Ret- rospectively analysed 218 patients found abnormal gastric lesions by WLE or ME-NBI. The patients were divided into observa- tion group（ 110 cases） and control group（ 108 cases） according to the type of endoscopy. Observation group was given ME- NBI examination, control group was given WLE examination. Two groups of lesions were biopsy or endoscopic resection of spec- imens pathological examination. Compared the endoscopic diagnosis and pathological diagnosis of two groups. Calculated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of endoscopic diagnosis. Results In control group, 80 cases of cancerous lesions were diagnosed by WLE endoscopy, of which 10 cases were cancerous and 70 cases were non-cancerous confirmed by the final ＂gold standard＂ pathological diagnosis. WLE endoscopic diagnosis of non-cancerous lesions in 28 cases, the final ＂gold standard＂ pathological diagnosis confirmed non-cancerous. In observation group, ME-NBI endoscopic diagnosis of cancerous lesions in 14 cases, the final ＂gold standard＂ pathological diagnosis of which confirmed 13 cases of caneeration and 1 case of non-cancerous lesions. ME-NBI endoscopic diagnosis of non-cancerous lesions in 96 cases, the final ＂gold standard＂ pathological diagnosis confirmed that 94 cases of non-cancerous,cancerous in 2 cases. Of the 108 pa- tients in control group ,98 were non-cancerous lesions and 10 were cancerous lesions. The pathological diagnosis of 110 patients in observation group confirmed 95 non-cancerous lesions and 15 cancerous lesions. The diagnosis of EGC specificity, positive predictive value and accuracy in observed group was significantly higher than control group, the differences were statistically significant （ P 〈 0.05 ）. Conclusio

关 键 词：早期胃癌 癌 放大胃镜 窄带成像技术 

分 类 号：R735.2[医药卫生—肿瘤]