白光内镜与放大内镜联合窄带光成像技术对良性病变中肠型胃腺瘤的诊断作用比较  

Comparison of diagnostic efficacy of conventional white light endoscopy and magnifying endoscopy combined with narrow-band imaging for intestinal-type gastric adenoma in benign lesions

作　　者：滕腊梅 章庆伟[1] 张昕恬 陈锦南 周菁[1] 李晓波[1] Teng Lamei;Zhang Qingwei;Zhang Xintian;Chen Jinnan;Zhou Jing;Li Xiaobo(Division of Gastroenterology and Hepatology,Renji Hospital,School of Medicine,Shanghai Jiaotong University , Shanghai Institute of Digestive Disease,Shanghai 200001,China)

机构地区：[1]上海交通大学医学院附属仁济医院消化内科上海市消化疾病研究所,上海200001

出　　处：《中华消化内镜杂志》2019年第8期558-562,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的比较常规白光内镜与放大内镜联合窄带光成像技术在良性病变中诊断肠型胃腺瘤的准确性。方法收集2016年1月至2017年12月在上海仁济医院消化内镜中心经白光内镜检查怀疑胃早期肿瘤性病变的连续患者,择期再次行白光内镜及放大内镜联合窄带光成像检查,分别记录其内镜诊断结果,并以活检或术后病理诊断为评判标准,除外癌变病灶,比较白光内镜和放大内镜联合窄带光成像内镜在良性病灶中区分肠型胃腺瘤和其他非腺瘤病变的诊断准确性。结果共纳入232例患者(232个病灶),其中肠型胃腺瘤124例,其他非腺瘤性良性病灶(萎缩、溃疡、增生、非肠型胃腺瘤相关低级别上皮内瘤变等)108例,放大内镜联合窄带光成像区分肠型胃腺瘤与非腺瘤性良性病变的灵敏度、阴性预测值、准确率均显著高于白光内镜(分别为92.7%比71.8%,91.6%比73.7%,91.8%比80.6%,P均<0.01),特异度一致(均为90.7%),阳性预测值和白光内镜相比(92.0%比89.9%),差异无统计学意义(P>0.05)。结论放大内镜联合窄带光成像鉴别肠型胃腺瘤与非腺瘤性良性病变的诊断效能显著高于白光内镜。Objective To compare the diagnostic accuracy of white light endoscopy ( WLE) and magnifying endoscopy combined with narrow-band imaging ( ME-NBI) for intestinal-type gastric adenoma in benign lesions. Methods Data of patients with suspected early gastric neoplastic lesions diagnosed with WLE were collected from Shanghai Renji Hospital from January 2016 to December 2017. Patients with suspected early gastric neoplastic lesions by WLE were examined with WLE, ME-NBI and targeted biopsy again within 2 weeks. The results of WLE, ME-NBI and biopsy were recorded. Using pathological diagnosis as the golden standard, diagnostic efficacy of WLE and ME-NBI for intestinal-type gastric adenoma and other non-adenoma lesions was evaluated. Results A total of 232 patients ( 232 lesions) were included, i. e., 124 intestinal-type gastric adenoma and 108 other non-adenoma lesions such as atrophy, ulcers, hyperplasia, low-grade intraepithelial neoplasia, etc.. The sensitivity, negative predictive value and accuracy of ME-NBI in intestinal-type gastric adenoma were higher than those of WLE (92. 7% VS 71. 8%,91.6% VS 73. 7%, 91. 8% VS 80. 6%, all P <0. 01). The specificity was consistent ( both 90. 7%). There was no significant difference in the positive predictive value between WLE and ME-NBI (92.0% VS 89. 9%, P > 0. 05 ). Conclusion Diagnostic efficacy of ME-NBI in intestinal-type gastric adenoma from other non-adenoma lesions is significantly higher than that of WLE.

关 键 词：腺瘤 胃肿瘤 内窥镜检查 胃肠道 窄带光成像 

分 类 号：R735.2[医药卫生—肿瘤]