放大内镜和内镜窄带光成像下胃癌病变的特点及与病理分型的关系  

Pathological characteristics of gastric cancer and the relationship with pathological classification on magnifying endoscopy with narrow-band imaging

作　　者：赵亮 冯璐璐 王笑楠 ZHAO Liang;FENG Lu-lu;WANG Xiao-nan(Department of Gastroenterology,Central Hospital of Sujiatun District,Shenyang 110101,China)

机构地区：[1]辽宁省沈阳市苏家屯区中心医院消化内科,沈阳110101

出　　处：《中国肿瘤临床与康复》2022年第1期55-59,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨放大内镜和内镜窄带光成像(ME-NBI)下的胃癌患者病变特点与其病情诊断及病理分型的关系。方法选取2019年1月至2020年12月间沈阳市苏家屯区中心医院收治的120例胃癌患者作为研究对象,病理结果显示,慢性胃炎级肠上皮化生患者34例,低级别上皮内瘤变患者35例,早癌患者32例,浸润癌患者19例,分别对患者开展放大成像的窄带光成像、醋酸处理后的窄带光成像以及联合诊断分析,分析胃癌患者ME-NBI下的病变特点与其病情诊断及病理分型的关系。结果通过对三种诊断手段的图像质量分析,三组诊断手段的图像质量比较,差异有统计学意义(P <0.05)。经过两两比较,患者的三种诊断方式的图像质量从高到低依次为联合组、ME-NBI组以及NBI组,差异均有统计学意义(均P <0.05)。通过对三种诊断手段的诊断情况进行分析,三种诊断方式与病理诊断结果的一致性较强,差异有统计学意义(P <0.05)。通过对患者的病理分型与微腺管、微血管以及分界线的相关性分析,患者的病理分型与微腺管、微血管以及分界线呈现显著相关,差异有统计学意义(P <0.05)。进一步分析显示,慢性胃炎及肠上皮化生、低级别上皮内瘤变与微腺管以及微血管的规则程度呈现正相关,与分界线呈现负相关,早癌以及浸润癌患者与微腺管以及微血管的规则程度呈现负相关,与分界线呈现正相关,差异有统计学意义(P <0.05)。联合诊断对于慢性胃炎及肠上皮化生、低级别上皮内瘤变、早癌以及浸润癌患者的诊断灵敏度显著高于单独诊断,差异有统计学意义(P <0.05)。结论胃癌患者ME-NBI下的病变特点与其病情诊断及病理分型显著相关,可作为日后早期诊断的重要依据。Objective To study the relationship between the pathological characteristics and pathological classification of gastric cancer on magnifying endoscopy with narrow-band imaging(ME-NBI).Methods One hundred and twenty patients with gastric cancer were selected at Central Hospital of Sujiatun District from January 2019 to December 2020. The pathological results showed that 34 patients had chronic gastritis grade intestinal metaplasia,35 patients had low-grade intraepithelial neoplasia,32 patients had early-stage cancer and 19 patients had invasive cancer,respectively. ME-NBI,narrow-band imaging after the lesion was sprayed with acetic acid and the combined diagnostic approach of the above two were performed.The relationship between the pathological characteristics and pathological classification of gastric cancer on ME-NBI was analyzed. Results There was statistical significance in the image quality among the three diagnostic methods(P < 0. 05). The combined diagnostic approach had the highest image quality followed by ME-NBI and then NBI(all P < 0. 05). There was a strong consistency between the above three diagnostic results and the pathological diagnosis results(all P < 0. 05). The pathological classification of gastric cancer was associated with microglandular duct,microvasculature and demarcation line(all P < 0. 05). Further analysis showed that chronic gastritis and upper intestinal metaplasia and low-level intraepithelial neoplasia were positively associated with the regular degree of microglandular duct and microvasculature and negatively associated with demarcation line(all P < 0. 05). Early stage cancer and invasive cancer were negatively associated with the regular degree of micro glandular tubes and micro blood vessels and positively associated with the demarcation line(all P < 0. 05). The sensitivity of combined diagnosis for chronic gastritis and intestinal metaplasia,low-grade intraepithelial neoplasia,early stage cancer and invasive cancer was significantly higher than that of each single diagnosis(al

关 键 词：胃肿瘤 窄带光成像 病例分型 胃镜 诊断 

分 类 号：R735.2[医药卫生—肿瘤]