联动成像内镜与白光内镜对胃黏膜感染幽门螺杆菌的诊断价值比较  

Diagnostic value of linked color imaging for Helicobacter Pylori infection compared with white light imaging

作　　者：王菲[1] 陈石岩[2] 谭新华[2] 买买提吐尔逊.巴拉提 刘江[1] 钟豪杰[3] 孙焕焕[1] 陈羽[3] 白杨[1] WANG Fei;CHEN Shiyan;TAN Xinhua;Maimaitituerxun Balati;LIU Jiang;ZHONG Haojie;SUN Huanhuan;CHEN Yu;BAI Yang(Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院,广州市510515 [2]新疆喀什地区第一人民医院,844000 [3]广东药科大学附属第一医院,广州市510080

出　　处：《实用医学杂志》2017年第14期2325-2328,共4页The Journal of Practical Medicine

基　　金：广东省科技厅资助项目(编号:2016A020212022);广东省科技厅资助项目(编号:2016A020212007);中国健康促进基金会(横向课题,内镜下诊断幽门螺杆菌感染胃黏膜病变研究)

摘　　要：目的比较联动成像内镜(LCI)与传统白光内镜对胃黏膜幽门螺杆菌(Hp)感染的诊断价值。方法用白光和LCI模式分别观察胃黏膜,用取色软件测量两种模式下可疑Hp感染区域的红色(R)、绿色(G)、蓝色(B)的组成值,并对可疑部位取活检行病理检测,R/(G+B)比值用于建立预测Hp感染的受试者工作特征曲线(ROC),并计算曲线下面积(AUC)、cut-off值及灵敏度和特异度。结果共纳入47例研究对象,其中维吾尔族23例,平均49岁。共获得91例病理组织,确诊Hp感染44例。LCI模式建立的曲线的AUC为0.616,cut-off值为0.967,灵敏度为0.955,特异度为0.298;白光模式建立的曲线的AUC为0.529,cut-off值为2.638,灵敏度为0.455,特异度为0.766。LCI诊断汉族和维吾尔族Hp感染的AUC分别为0.65、0.549。LCI诊断萎缩性胃炎和非萎缩性胃炎患者Hp感染的AUC分别为0.628、0.603。结论 LCI模式较白光模式诊断胃黏膜Hp感染具有更高的诊断效能,可作为一种客观的内镜下辅助判断胃黏膜Hp感染的定量方法。Objective To investigate the ability of linked color imaging(LCI)for diagnosing Helicobacter Pylori(Hp)infection compared with conventional white light imaging(WLI).Methods We prospectively collected subjects who underwent gastroscopy.Images under both WLI and LCI were recorded and analyzed.Software was used to measure pixel brightness for red(R),green(G),blue(B)of endoscopic images from suspected lesion sites.Biopsies were taken from these sites and Warthin?Starry silver staining was used to detect if Hp was present.R/(G+B)value was used to construct receiver operating characteristic curve(ROC)to predict Hp infection and the area under curve(AUC),cut?off point,sensitivity,as well as specificity were calculated with thepatho?logy as the gold standard.Results Forty?seven subjects(23men,24women;23Uygur subjects,24Han subjects)were included in a mean age of49years old.Ninety?one biopsies were obtained.Forty?four biopsies(48.4%)were Hp positive according to the pathology.The AUC of LCI was0.616,with the cut?off point at0.967and sensitivity at0.955and specificity at0.298.The AUC of WLI was0.529,with cut?off point at2.638and sensitivity at0.455and specificity at0.766.The AUC of Han and Uygur subjects were0.650and0.549by LCI.The AUC of atrophy gastritis subjects and non?atrophy gastritis subjects were0.628and0.603.Conclusion LCI was superior to WLI in predicting Hp infection.LCI may act as an objective and quantified endoscopic diagnostic method in Hp infection.

关 键 词：联动成像 白光内镜 幽门螺杆菌 诊断 

分 类 号：R573[医药卫生—消化系统]