国产高清放大胃镜对胃平坦型病变的应用价值研究  

Application of Domestic Made High Definition Magnifying Gastroscope for Gastric Flat Lesions

作　　者：李雅惠 薛寒冰[2] 沈煜枫[2] 龚帅[2] 高云杰[2] 戈之铮[2] LI Yahui;XUE Hanbing;SHEN Yufeng;GONG Shuai;GAO Yunjie;GE Zhizheng(Department of Gastroenterology and Hepatology, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang Province (315336);Division of Gastroenterology and Hepatology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University,Shanghai Institute of Digestive Disease, Shanghai)

机构地区：[1]宁波市杭州湾医院消化内科,315336 [2]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

出　　处：《胃肠病学》2019年第9期524-527,共4页Chinese Journal of Gastroenterology

基　　金：上海市科学技术委员会科研计划项目(15DZ1940202)

摘　　要：背景:胃镜检查是早期胃癌的有效筛查手段,目前主要依赖于价格高昂的进口内镜设备。目的:评估国产高清放大胃镜诊断胃平坦型病变的应用价值。方法:纳入2018年1月—2018年12月在上海仁济医院行常规白光内镜检查并发现局灶性平坦型胃黏膜病变的患者99例,采用国产澳华AQ-200内镜系统进行放大胃镜检查,根据VS分型判断病变性质。以病理诊断结果为金标准,评价该设备对胃平坦型病变的诊断效能及其与病理诊断结果的一致性。结果:国产高清放大胃镜诊断早期胃癌/癌前病变的敏感性、特异性和准确性分别为92.9%、98.8%和98.0%,阳性预测值和阴性预测值分别为92.9%和98.8%,内镜诊断与病理诊断结果具有高度一致性(κ=0.917)。早期胃癌/癌前病变组内镜下边界线、微血管形态不规则或消失、微腺管结构不规则或消失的比例显著高于非早期胃癌/癌前病变组(P<0.05)。结论:国产高清放大胃镜可满足临床内镜诊治要求,使在基层医疗机构开展早期胃癌筛查和诊治工作成为可能。Background:Gastroscopy is an effective method for screening early gastric cancer (EGC), which is mainly relied on expensive imported endoscopic equipment. Aims: To evaluate the performance of domestic made high definition magnifying gastroscopy for diagnosis of gastric flat lesions. Methods: A total of 99 patients with focal flat gastric mucosal lesions detected by conventional white-light endoscopy at Shanghai Renji Hospital from Jan. 2018 to Dec. 2018 were enrolled. Magnifying gastroscopy was performed using domestic made AOHUA AQ-200 endoscopic system. Nature of the lesion was assessed according to VS classification. Using pathological diagnosis as gold standard, the diagnostic performance of the domestic made gastroscopy for gastric flat lesions was evaluated, and the consistency of endoscopic and pathological results was analyzed. Results: The sensitivity, specificity and accuracy of domestic made high definition magnifying gastroscopy for diagnosis of EGC/precancerous lesions were 92.9%, 98.8% and 98.0%, respectively;the positive predictive value and negative predictive value were 92.9% and 98.8%, respectively. The endoscopic diagnosis was highly consistent with the pathological results with a kappa value of 0.917. The incidence of demarcation line, irregular or disappeared microvascular morphology, and irregular or disappeared microsurface glandular structure in EGC/precancerous lesions was significantly higher than those in non-EGC/precancerous lesions (P<0.05). Conclusions: Domestic made high definition magnifying gastroscope can meet the requirements of endoscopic diagnosis and treatment, which allows the primary care institutions to carry out the job of screening, diagnosis and treatment of EGC.

关 键 词：胃镜检查 国产 胃平坦型病变 诊断 

分 类 号：R73[医药卫生—肿瘤]