窄带成像放大内镜及超声内镜对早期食管癌浸润深度的诊断价值  

Value of Magnifying Endoscopy with Narrow Band Imaging and Endoscopic Ultrasound for Predicting the Invasion Depth of Early Esophageal Cancer

作　　者：葛存锦[1] 仝巧云[1] 郑世华[1] 周明东[1] Ge Cunjin;Tong Qiaoyun;Zheng Shihua;Zhou Mingdong(Department of Gastroenterology,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University&Institute of Digestive Diseases,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院(宜昌市中心人民医院)消化内科&三峡大学消化疾病研究所

出　　处：《巴楚医学》2019年第4期34-38,共5页Bachu Medical Journal

基　　金：湖北省自然科学基金项目（No:2019CFB313）

摘　　要：目的:探讨窄带成像放大内镜(ME-NBI)及超声内镜对早期食管癌浸润深度的诊断价值。方法:回顾我院2017年3月~2019年7月共84例早期食管癌患者,术前均接受了ME-NBI检查,其中有54例接受了高频微探头(20 MHZ)超声内镜检查。84例患者中有75例接受内镜黏膜下剥离术(ESD),9例接受外科手术。ME-NBI根据乳头内毛细血管袢(IPCL)的AB分型来预测浸润深度。分析术前ME-NBI和超声内镜对早期食管癌浸润深度的诊断价值。结果:根据病理结果,84例食管早癌中,黏膜内癌(M)74例,黏膜下层癌(SM)10例。接受了超声内镜检查的54例患者中,有47例为M,7例为SM。ME-NBI对早期食管癌浸润深度的总体诊断准确率为90.48%(76/84),其中对M1/M2的诊断准确率为94.83%(55/58),M3/SM1的诊断准确率为81.82%(18/22),SM2及以上的诊断准确率为75.00%(3/4)。超声内镜对早期食管癌浸润深度的诊断准确率为77.78%(42/54),其中对M的诊断准确率为76.60%(36/47),对SM的诊断诊断准确率为85.71%(6/7)。结论:ME-NBI及超声内镜对早期食管癌的浸润深度均有较高的诊断准确率,可应用于早期食管癌术前诊断病变浸润深度。Objective:To investigate the value of magnifying endoscopy with narrow band imaging(ME-NBI)and endoscopic ultrasound(EUS)in predicting the invasion depth of early esophageal cancer.Methods:A total of 84 early esophageal cancer patients in our hospital were reviewed from March 2017 to July 2019.All patients underwent ME-NBI preoperative examination,including 54 patients who underwent high-frequency microprobe(20 MHZ)EUS in the meantime.There were 75 patients subjected with endoscopic submucosal dissection(ESD),and the other 9 patients underwent surgery.Invasion depth of early esophageal cancer was assessed using the AB classification of intra-epithelial papillary capillary loop(IPCL).The diagnostic value of ME-NBI and EUS were analyzed in early esophageal cancer patients before surgery.Results:There were 74 cases of mucosal carcinoma(M)and 10 cases of submucosal carcinoma(SM)according to pathology results.Among 54 patients underwent EUS,there were 47 patients diagnosed as stage M,and 7 patients diagnosed as stage SM.The overall diagnosis accuracy of ME-NBI was 90.48%(76/84)in early esophageal cancer patients.The diagnosis accuracy of ME-NBI was 94.83%(55/58)for M1/M2,81.82%(18/22)for M3/SM1,and 75.00%(3/4)for SM2 and above,respectively.The overall diagnosis accuracy of EUS was 77.78%(42/54).The diagnosis accuracy of EUS was 76.60%(36/47)for M,and 85.71%(6/7)for SM,respectively.Conclusion:Both ME-NBI and EUS have optimal diagnostic accuracy in predicting the invasion depth of early esophageal cancer,both can be used to diagnose the depth of tumor before ESD or surgery.

关 键 词：早期食管癌 浸润深度 放大内镜 超声内镜 上皮乳头内毛细血管袢 

分 类 号：R536.1[医药卫生—内科学]