胃低级别上皮内瘤变内镜精准活检策略探讨  

The strategy of precise endoscopic biopsy of gastric low-grade intraepithelial neoplasia

作　　者：植中敬[1] 安玉靖 陈少华[1] 何国开 邵少慰[1] 谭飞鸥 伍梅 ZHI Zhong-jing;AN Yu-jing;CHEN Shao-hua(Department of Gastroenterology,Second People's Hospital of Zhaoqing City,Zhaoqing 526020,China)

机构地区：[1]肇庆市第二人民医院消化内科,广东肇庆526020

出　　处：《中国处方药》2021年第7期174-175,共2页Journal of China Prescription Drug

基　　金：肇庆市科技创新指导类项目(180612094164574)。

摘　　要：目的探讨胃低级别上皮内瘤变内镜精准活检策略。方法选取2018年1月~2020年1月经胃镜和活组织病理检查诊断为胃低级别上皮内瘤变患者98例,随机分为对照组(49例)和观察组(49例),对照组采用富士普通内镜行胃镜检查,观察组采用高清内镜配合染色内镜技术、高清放大内镜技术、改进内镜活检技术,比较两组患者诊断参数和术前、EMR术后癌变、非癌变诊断情况。结果观察组特异度97.96%、敏感度87.76%、正确率95.92%和阴性、阳性预测值97.96%、100.00%均显著高于对照组83.67%、71.43%、81.63%、75.51%、83.67%(P<0.05)。观察组术前和术后癌变、非癌变诊断情况差异无统计学意义,对照组术后EMR癌变患者显著少于术前,非癌变患者显著多于术前。结论对于低级别上皮内瘤变采用高清内镜配合染色内镜技术、高清放大内镜技术、改进内镜活检技术进行活检,可提高检测的准确性并准确诊断是否发生癌变。Objective To explore the strategy of precise endoscopic biopsy of gastric low-grade intraepithelial neoplasia.Methods From January 2018 to January 2020,98 patients with low-grade gastric intraepithelial neoplasia diagnosed by gastroscopy and biopsy in our hospital were selected and randomly divided into control group(49 cases)and observation group(49 cases),the control group used Fuji ordinary endoscopy for gastroscopy,and the observation group used high-definition endoscopy with dyeing endoscopy,high-definition magnifying endoscopy,and improved endoscopic biopsy technology.Compare the diagnosis parameters of the two groups of patients and the diagnosis of cancerous and non-cancerous changes before and after EMR.Results The observation group had a specificity of 97.97%,a sensitivity of 87.76%,a correct rate of 95.92%and a negative,positive predictive value of 97.96%,100.00%were significantly higher than the control group 83.67%,71.43%,81.63%,75.51%,83.67%(P<0.05).There was no statistically significant difference in the diagnosis of cancerous and non-cancerous changes in the observation group before and after operation.In the control group,the number of patients with EMR cancerous changes after surgery was significantly less than before surgery,and the number of non-cancerous patients was significantly more than before.Conclusion For low-grade intraepithelial neoplasia,using high-definition endoscopy with dyeing endoscopy,high-definition magnifying endoscopy,and improved endoscopic biopsy technology for biopsy can improve the accuracy of detection and accurately diagnose whether cancer has occurred.

关 键 词：胃低级别上皮内瘤变 内镜精准活检 策略 

分 类 号：R735.2[医药卫生—肿瘤]