窄带光成像放大内镜下B2型血管预判表浅食管鳞状细胞癌浸润深度的准确率及影响因素分析  

Accuracy and influencing factors of type B2 vessels for predicting the invasion depth of superficial esophageal squamous cell carcinoma under narrow band imaging-magnifying endoscopy

作　　者：林旭[1] 林晓露[1] 邓万银[1] 梁玮[1] Lin Xu;Lin Xiaolu;Deng Wan-yin;Liang Wei(Department of Digestive Endoscopy,Fujian Provincial Hospital,rovincial Clinic Medical College,Fujian Medical University,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院消化内镜中心,福州350001

出　　处：《中华消化内镜杂志》2022年第2期108-113,共6页Chinese Journal of Digestive Endoscopy

基　　金：国家自然科学基金(61675043)。

摘　　要：目的评估窄带光成像放大内镜(narrow band imaging-magnifying endoscopy, NBI-ME)下B2型血管预测表浅食管鳞状细胞癌浸润深度的准确率, 并探索预测过度及不足的影响因素。方法 2015年1月-2020年4月在福建省立医院内镜中心完成NBI-ME评估食管肿瘤浸润深度, NBI-ME下发现B2型血管, 并经术后病理证实为表浅食管鳞状细胞癌的86例病例合计86处癌灶纳入病例对照研究。按术后病理结果分成预测正确组(n=25)和预测错误组(n=61), 计算预测的准确率。进一步将预测错误组分成预测过度组(n=49)和预测不足组(n=12), 分别与预测正确组进行对比分析, 以分别发现预测过度和预测不足的影响因素, 再进一步行多因素Logistic回归分析, 探寻各自的独立危险因素。结果 ME-NBI下B2型血管预测表浅食管鳞状细胞癌浸润深度的准确率仅为29.07%(25/86), 其中预测过度率和不足率分别为56.98%(49/86)和13.95%(12/86)。单因素分析发现:B2区域分类构成(χ^(2)=36.25, P<0.001)、有无内镜下显著特征(即结节、增厚、明显凹陷, χ^(2)=22.90, P<0.001)、B2血管周围是否伴有炎症侵蚀(χ^(2)=9.54, P=0.004)与B2型血管过度预测表浅食管鳞状细胞癌浸润深度有关, 内镜下有无显著特征与B2型血管预测表浅食管鳞状细胞癌浸润深度不足有关(P=0.016)。多因素Logistic回归分析结果显示:小区域B2(P<0.001, OR=241.988, 95%CI:15.229~3 845.252)和B2血管周围伴有炎症侵蚀(P=0.033, OR=12.801, 95%CI:1.226~133.713)均是B2型血管过度预测表浅食管鳞状细胞癌浸润深度的独立危险因素, 而内镜下有显著特征是B2型血管过度预测表浅食管鳞状细胞癌浸润深度的独立保护因素(P<0.001, OR=0.012, 95%CI:0.001~0.150);内镜下有显著特征是B2型血管预测预测表浅食管鳞状细胞癌浸润深度不足的独立危险因素(P=0.027, OR=7.899, 95%CI:1.259~49.565)。结论仅依据NBI-ME下B2型血管预测表浅食管鳞状细胞癌浸�Objective To evaluate type B2 vessels for predicting the invasion depth of superficial esophageal squamous cell carcinoma(SESCC)under narrow band imaging-magnifying endoscopy(NBI-ME),and to analyse the influencing factors of over-prediction and under-prediction.Methods A total of 86 SESCC patients with 86 lesions confirmed by postoperative pathology,who underwent NBI-ME to evaluate the invasion depth of esophageal tumor and were observed for type B2 vessels in Department of Digestive Endoscopy of Fujian Provincial Hospital from January 2015 to April 2020,were included in the case-control study.According to the postoperative pathological results,the patients were divided into the correct prediction group(n=25)and the wrong prediction group(n=61),and the accuracy of prediction was calculated.The wrong prediction group was further divided into the over-prediction group(n=49)and the under-prediction group(n=12)to find the influencing factors of over-prediction and under-prediction,respectively.Further,multivariate Logistic analysis was performed to explore the independent influential factors for the prediction.Results The accuracy of type B2 vessels under NBI-ME for predicting the invasion depth of SESCC was only 29.07%(25/86),and the over-prediction rate and under-prediction rates were 56.98%(49/86)and 13.95%(12/86),respeetively.Univariate analysis showed that the classification of type B2 area(χ^(2)=36.25,P<0.001),the distinet endoscopic features(nodules,thickening and obvious depression),(χ^(2)=22.90,P<0.001),and inflammation around type B2 vessels(χ^(2)=9.54,P=0.004)were related to the over-prediction of the invasion depth of SESCC,and the distinct endoscopic features were related tothe under-prediction of the invasion depth(P=0.016).Multivariate Logistic regression analysis showed that B2-narrow(type B2 area 65 mm)(P<0.001,OR=241.988,95%CI:15.229-3845.252)and inflammation around type B2 vessels(P=0.033,OR=12.801,95%CI:1.226-133.713)were independent risk factors for over-predicting the invasion depth of SESCC,

关 键 词：食管鳞状细胞癌 表浅食管鳞状细胞癌 浸润深度 窄带光成像放大内镜 B2型血管 

分 类 号：R735.1[医药卫生—肿瘤]