窄带成像-放大内镜在上消化道早期癌及癌前病变筛查中的应用研究  

The Application Research of narrowband imaging-magnifying Endoscopy in screening early Cancer of upper digestive Tract and precancerous Lesions

作　　者：张华 ZHANG Hua(Second Department of Internal Medicine,Beihai Hospital,Xuchang,Xuchang Henan 461000,China)

机构地区：[1]许昌北海医院消化内科,河南许昌461000

出　　处：《临床研究》2024年第6期140-143,共4页Clinical Research

摘　　要：目的探究窄带成像-放大内镜(NBI-ME)在上消化道早期癌及癌前病变筛查中应用。方法选取2021年7月至2023年7月在许昌北海医院治疗的68例疑似为上消化道早期癌及癌前病变的患者,所有患者均接受常规内镜、NBI-ME检查,以病理结果作为金标准,分析诊断效能。结果68例疑似消化道早期癌及癌前病变患者经病理检查后,提示良性病变为8例,癌前病变22例、消化道早期癌18例、进展癌20例。NBI-ME诊断准确率、特异性为97.06%、100.00%,高于常规内镜(80.88%、62.50%),差异有统计学意义(P<0.05);NBI-ME敏感性(96.67%)高于常规内镜(83.33%),差异无统计学意义(P>0.05);良性病变与肿瘤病变在NBI-ME镜下特征表现中,分界线、黏膜微血管、黏膜表面腺管、腺管密度增加及黏膜微血管密度增加存在差异,且差异有统计学意义(P<0.05);NBI-ME检查病变轮廓、消化道黏膜、微血管形态清晰程度高于常规内镜,差异有统计学意义(P<0.05)。结论NBI-ME用于上消化道早期癌及癌前病变筛查中具有较高诊断效能,特异度高,同时能提供清晰的图像以供于临床医师诊断,为临床诊断及治疗提供指导依据。Objective To explore the application of narrow-band imaging-magnifying endoscopy(NBI-ME)in screening for early cancer of upper digestive tract and precancerous lesions.Methods A total of 68 patients suspected of early cancer of upper digestive tract and precancerous lesions treated at Beihai Hospital in Xuchang from July 2021 to July 2023 were selected.All patients underwent routine endoscopic and NBI-ME examinations,and pathological results were used as the gold standard to analyze diagnostic efficacy.Results After pathological examination,68 suspected patients with early cancer of upper digestive tract and precancerous lesions were found to have 8 cases of benign lesions,22 cases of precancerous lesions,18 cases of early cancer of upper digestive tract,and 20 cases of advanced cancer.The diagnostic accuracy and specificity of NBI-ME were 97.06%and 100.00%,which were higher than those of conventional endoscopy(80.88%and 62.50%),and the difference was statistically significant (P < 0.05);The sensitivity of NBI-ME (96.67%) was higher than that of conventional endoscopy (83.33%), and the difference was not statistically significant (P > 0.05);There are differences in the characteristic manifestations of benign lesions and tumor lesions under NBI-ME microscopy, including the boundary line, mucosal microvasculature, mucosal surface glandular ducts, increased glandular duct density, and increased mucosal microvascular density, with statistical significance (P < 0.05);The clarity of lesion contour, gastrointestinal mucosa, and microvascular morphology in NBI-ME examination was higher than that in conventional endoscopy, and the difference was statistically significant (P < 0.05). Conclusion NBI-ME has high diagnostic efficacy and specificity in screening early cancer of upper digestive tract and precancerous lesions, and can provide clear images for clinical diagnosis, providing guidance for clinical diagnosis and treatment.

关 键 词：窄带成像-放大内镜 上消化道癌 癌前病变 筛查 

分 类 号：R573[医药卫生—消化系统]