蓝激光成像技术联合碘染色在早期食管癌性病变中的应用  

Application of blue laser imaging combined with iodine staining for early esophageal cancer and precancerous lesions

作　　者：陈雪 文保钢 任益 赵伦 高志芳 CHEN Xue;WEN Baogang;REN Yi;ZHAO Lun;GAO Zhifang(Department of Gastroenterolgy,the People′s Hospital of Yubei District,Chongqing 401120,China;Gynecological Oncology Center,Chongqing University Cancer Hospital/Chongqing Cancer Institute/Chongqing Cancer Hospital,Chongqing 400030,China)

机构地区：[1]重庆市渝北区人民医院消化内科,重庆401120 [2]重庆大学附属肿瘤医院/重庆市肿瘤研究所/重庆市肿瘤医院妇科肿瘤中心,重庆400030

出　　处：《国际检验医学杂志》2023年第S01期45-50,共6页International Journal of Laboratory Medicine

基　　金：重庆市渝北区科技计划项目〔2021(农社)24〕。

摘　　要：目的探究内镜下蓝激光成像技术(BLI)联合碘溶液染色在诊断食管早期癌性病变中的价值。方法选取2020年9月至2022年6月通过问卷调查筛查出食管早癌高危人群120例,通过随机数字表法分为4组:白光内镜组(30例)、蓝激光成像技术组(30例)、碘染色组(30例)、BLI联合碘染色组(30例),以病检结果为诊断的金标准,应用Kappa一致性检验,评价4组内镜检查结果与病理结果的一致性。结果对于食管早期癌性病变的筛查,白光组、蓝激光成像技术组、碘染色组以及蓝激光成像联合碘染色组与病理诊断的总体符合率分别为:80.00%、83.33%、86.67%、93.33%,灵敏度分别为:75.00%、80.00%、81.82%、90.91%,特异度分别为:83.33%、85.00%、89.47%、94.74%,阳性预测值分别为:75.00%、72.73%、81.82%、90.91%,阴性预测值分别为:83.33%、89.47%、89.47%、94.74%,以及Kappa值分别为:0.583、0.634、0.713、0.856。蓝激光与碘染色联合组与病理诊断的总体符合率、灵敏度、特异度、阳性预测值、阴性预测值、Kappa值均高于白光内镜、蓝激光成像组及碘染组。结论蓝激光成像技术联合碘染色有助于内镜医生提高对食管早期癌性病变的检出率。Objective To explore the role of endoscopic blue laser imaging(BLI)combined with iodine staining in the diagnosis of early esophageal cancer and precancerous lesions.Methods From September 2020 to June 2022,120 high-risk people with early esophageal cancer screened by questionnaire survey were selected and divided into four groups by random number table method:White light endoscopy(WLE)(30 cases),BLI(30 cases),iodine solution staining(30 cases),BLI combined with iodine staining(30 cases).With the test results as the gold standard for diagnosis,Kappa test was used to evaluate the consistency between endoscopic findings and pathological findings in the four groups.Results For the screening of early esophageal cancer and precancerous lesions,The overall consistency rate between endoscopy and pathological examination of WLE,BLI,iodine staining group and BLI combined with iodine staining group were 80.00%,83.33%,86.67%,93.33%,and the sensitivities were as follows:75.00%,80.00%,81.82%,90.91%,the specificity were:83.33%,85.00%,89.47%,94.74%,positive predictive values were 75.00%,72.73%,81.82%,90.91%,negative predictive values were 83.33%,89.47%,89.47%,94.74%,and Kappa values were 0.583,0.634,0.713,0.856,respectively.The overall coincidence rate,sensitivity,specificity,positive predictive value,negative predictive value and Kappa value of BLI with iodine staining group were higher than the other three groups.Conclusion BLI combined with iodine staining can help endoscopists improve the detection rate of early esophageal cancer lesions.

关 键 词：蓝激光成像技术 碘染色 食管癌性病变 

分 类 号：R735.1[医药卫生—肿瘤]