窄带成像技术联合放大内镜诊断早期胃癌的价值研究  

The value of narrow band imaging combined with magnifying endoscopy in the diagnosis of early gastric cancer

作　　者：丁元军 杨卫生 DING Yuan-Jun;YANG Wei-sheng(Department of Gastroenterology,the Second People's Hospital of Jingdezhen,333000 Jingdezhen,Jiangxi China)

机构地区：[1]景德镇市第二人民医院消化内科,江西景德镇333000

出　　处：《临床消化病杂志》2020年第4期221-223,共3页Chinese Journal of Clinical Gastroenterology

基　　金：景德镇市基金项目(No:20181SFZC043)。

摘　　要：[目的]探讨窄带成像技术联合放大内镜(narrow band imaging-magnifying endoscopy,NBI-ME)在早期胃癌诊断中的价值。[方法]首先在普通内镜下观察,发现可疑的恶性病变行NBI-ME观察,做出内镜下诊断,并行NBI-ME下靶向活检送病理检查。入选患者全部行内镜下切除或外科手术治疗,以术后病理为金标准,分析比较NBI-ME和内镜活检诊断早期胃癌的准确性。[结果]82例纳入本研究,最终术后切除病理示非癌性病变37例,早期胃癌45例。NBI-ME诊断早期胃癌的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为93.3%、81.0%、85.7%、90.9%、87.8%,内镜活检的对应值分别为66.6%、97.3%、96.7%、70.5%、80.4%。NBI-ME诊断早期胃癌的敏感度明显高于内镜活检(P<0.05),特异度低于内镜活检(P<0.05),两者的早期胃癌检测率比较差异无统计学意义(P>0.05)。[结论]NBI-ME检测早期胃癌具有较高的临床应用价值,可作为目前组织病理学诊断早期胃癌标准的有益补充;建议NBI-ME下符合早期胃癌诊断的患者予内镜下治疗或外科手术治疗。[Objective]To evaluate the value of narrow band imaging combined with magnifying endoscopy in the diagnosis of early gastric cancer.[Methods]The suspicious malignant lesions were observed by narrow band imaging-magnifying endoscopy(NBI-ME)under general endoscopy,and the diagnosis was made under NBI-ME and targeted biopsy was performed.The accuracy of NBI-ME and endoscopic biopsy in the diagnosis of early gastric cancer was analyzed and compared according to the gold standard of pathology.[Results]Eighty-two cases were included in this study,and 37 cases were non-cancerous lesions and 45 cases were early gastric cancer.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of NBI-ME in the diagnosis of early gastric cancer were 93.3%,81.0%,85.7%,90.9% and 87.8% respectively,the corresponding values of endoscopic biopsy were 66.6%,97.3%,96.7%,70.5% and 80.4% respectively.The sensitivity of NBI-ME in the diagnosis of early gastric cancer was higher than that of endoscopic biopsy.Specificity was opposite.There was no significant difference in detection rate of early gastric cancer between them.[Conclusion]NBI-ME is of great value in the diagnosis of early gastric cancer,which can be used as a useful supplement to the current histopathology criteria for early gastric cancer diagnosis.Endoscopic or surgical treatment is recommended for patients with NBI-ME consistent with an early diagnosis of gastric cancer.

关 键 词：早期胃癌 窄带成像技术联合放大内镜 病理活检 诊断价值 

分 类 号：R735.2[医药卫生—肿瘤]