窄带成像技术及放大内镜联合使用对胃平坦型病变的诊断价值  

The clinical value of endoscopic narrow band imaging combined with magnifying endoscopy in diagnosis of flat gastric lesions

作　　者：宋丽秀[1] 田书信[1] 刘芳[1] 陈卫刚[1] SONG Lixiu;TIAN Shuxin;LIU Fang;CHEN Weigang(Department of Gastroenterology,the First Affiliated Hospital of Medical College,Shihezi University,Shihezi 832002.Chin)

机构地区：[1]石河子大学医学院第一附属医院消化内科,新疆石河子832002

出　　处：《胃肠病学和肝病学杂志》2018年第8期912-914,共3页Chinese Journal of Gastroenterology and Hepatology

基　　金：石河子大学重大科技攻关项目(gxjs2012-2dgg01)

摘　　要：目的探讨窄带成像技术及放大内镜的联合使用对胃平坦型病变的临床诊断价值。方法普通白光胃镜检查发现胃平坦型可疑病变患者100例,随机分为对照组和观察组,对照组:普通白光胃镜+病检;观察组:普通白光胃镜+窄带成像+放大内镜检查,以病灶最可疑处取活检行病理检查,比较两组对诊断早期胃癌的灵敏度、特异度和准确率。结果对照组共检出早癌6例、低级别上皮内瘤变6例、肠化18例、炎症20例,而观察组检出早癌15例、低级别上皮内瘤变10例、肠化15例、炎症10例,对照组和观察组检查构成差异有统计学意义(P<0.05)。对照组诊断灵敏度为60.0%,特异度为95.0%,准确度为88.0%;观察组诊断灵敏度为93.8%,特异度为94.1%,准确度为94.0%,观察组灵敏度及准确度高于对照组,差异有统计学意义(P<0.05),两组特异度差异无统计学意义(P>0.05)。结论窄带成像技术及放大内镜联合使用能够提高胃平坦型病变患者早期胃癌及癌前病变的检出率,值得临床上推广与应用。Objective To investigate the clinical value of narrow band imaging and magnifying endoscopy（NBI-ME）in diagnosis of flat gastric lesions. Methods One hundred patients with suspicious gastric lesions under conventional white light endoscopy（WLE） were randomly divided into observation group and control group,50 cases in each group.The control group was examined with conventional white light endoscopy ＋ biopsy; in addition to the conventional white light endoscopy examination,the observation group was examined with narrow-band imaging and magnifying endoscopy,these suspicious lesions were examined by NBI-ME. Biopsy specimens were taken from suspicious lesions for pathological examination. The sensitivity, specificity and accuracy of the examinations were compared between two groups.Results Six cases of early gastric cancer,6 cases of low grade intraepithelial neoplasia,18 cases of intestinal metaplasia,20 cases of chronic inflammation were found in control group. In observation group,15 cases of early gastric cancers,10 cases of intraepithelial neoplasia and 15 cases of intestinal metaplasia,10 cases of chronic inflammation were found. The sensitivity,specificity and accuracy of diagnosis were 60%,95%,88%,respectively in control group,while they were93. 8%,94. 1%,94%,respectively in observation group. The sensitivity and accuracy in observation group were significantly higher than those in the control group（P〈 0. 05）. There was no significant difference in specificity between two groups（P 〉0. 05）. Conclusion NBI-ME can effectively improve the detection rate of early gastric cancer and precancerous lesions. It is worthy to recommend for application in the diagnosis of early gastric cancer.

关 键 词：白光胃镜 窄带成像 放大内镜 胃平坦型病变 

分 类 号：R573[医药卫生—消化系统]