放大窄带成像和血清学检测对萎缩性胃炎诊断的对比性评估  

Comparative evaluation of magnifying endoscopy and narrow band imaging and serological detection in the diagnosis of atrophic gastritis

作　　者：刘晶晶 崔静[1] 王颖[1] 万梦园 LIU Jingjing;CUI Jing;WANG Ying;WAN Mengyuan(Department of Gastroenterology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院消化内科,河南郑州450014

出　　处：《中国现代医生》2021年第1期40-43,F0003,共5页China Modern Doctor

摘　　要：目的评估放大窄带成像(ME-NBI)内窥镜检查和血清胃蛋白酶原(PG)Ⅰ、PGⅡ、PGⅠ/PGⅡ比值(PGR)、胃泌素-17(G-17)和CA724检查在检测老年萎缩性胃炎中的诊断价值。方法选取2019年3—10月至郑州大学第二附属医院消化内科就诊的150例患者,同时行血清学及ME-NBI检查,收集相关病例的发病年龄、性别、血清学相关指标及ME-NBI内窥镜检查图像,将其胃黏膜图像和血清学标志物与组织学进行比较,并行相关分析。结果选取的150例患者,ME-NBI诊断萎缩性胃炎(CAG)的准确度为0.91(95%CI 0.87~0.96),灵敏度、特异度分别为0.94、0.88;血清学指标G-17、PGⅠ、PGR和CA724在阈值分别为4.05、71.44、9.93、3.38时,灵敏度分别为80.2%、54.3%、82.7%、60.3%,特异度分别为73.9%、92.8%、65.2%、65.2%。G-17、PGⅠ、PGR和CA724的AUC分别为0.819、0.783、0.790、0.642。PGⅠ、PGR二者联合诊断CAG的AUC为0.827,灵敏度、特异度分别为79.0%、73.9%。ME-NBI与PGⅠ、PGR及PGⅠ、PGR二者联合诊断准确率相比,差异具有统计学意义(P<0.05)。结论尽管血清学指标对CAG有一定的诊断价值,但ME-NBI内窥镜检查在萎缩性胃炎诊断方面更准确。Objective To evaluate the diagnostic value of magnifying endoscopy and narrow band imaging(ME-NBI) endoscopy and serum pepsinogen(PG) Ⅰ, PGⅡ, PGⅠ/PGⅡ ratio(PGR), gastrin-17(G-17) and CA724 in detecting atrophic gastritis in the elderly. Methods A total of 150 patients admitted to the department of gastroenterology of the Second Affiliated Hospital of Zhengzhou University from March to October 2019 were examined by serology and ME-NBI at the same time. The age, gender, serological indexes and ME-NBI endoscopy images of related cases were collected. The gastric mucosa images and serological markers were compared with histology, and the correlation analysis was carried out in parallel. Results The accuracy of ME-NBI in diagnosing chronic atrophic gastritis(CAG) was 0.91(95%CI 0.87-0.96). Sensitivity and specificity were 0.94 and 0.88 respectively. When the serological indexes G-17, PGⅠ, PGR and CA724 had thresholds value of 4.05, 71.44, 9.93, 3.38, the sensitivity were 80.2%, 54.3%, 82.7%, 60.3%, and the specificity were 73.9%, 92.8%, 65.2%, 65.2%. The AUC of G-17, PGI, PGR and CA724 were 0.819, 0.783, 0.790, 0.642, respectively. The AUC of the combined diagnosis of CAG by PGⅠ and PGR was 0.827, and the sensitivity and specificity were 79.0% and 73.9%, respectively. Compared with ME-NBI, PGⅠ, PGR and combined diagnosis accuracy of PGⅠ, PGR, and the difference was statistically significant(P<0.05). Conclusion Although serological indexes have certain diagnostic value for CAG, ME-NBI endoscopy is more accurate in the diagnosis of atrophic gastritis.

关 键 词：放大窄带成像 胃蛋白酶原 胃泌素-17 CA724 萎缩性胃炎 

分 类 号：R573.3[医药卫生—消化系统]