内镜窄带成像联合幽门螺旋杆菌检测对早期胃癌的诊断价值  

Diagnostic value of narrow band imaging combined with Helicobacter pylori detection on early gastric cancer

作　　者：刘晓红 孙燕滨 李春雷 李芳芳 LIU Xiao-hong;SUN Yan-bin;LI Chun-lei;LI Fang-fang(Department of Gastroenterology,Jiaozhou Central Hospital of Qingdao,Jiaozhou 266300,Shandong,China)

机构地区：[1]青岛市胶州中心医院消化内科,山东胶州266300

出　　处：《川北医学院学报》2024年第5期668-671,共4页Journal of North Sichuan Medical College

基　　金：山东省青岛市医药卫生科研指导项目(2022-WJZD122)。

摘　　要：目的:探讨内镜窄带成像(NBI)联合幽门螺杆菌(HP)检测对早期胃癌的诊断价值。方法:选择80名胃部可疑病变患者为研究对象,患者均接受HP定性13C尿素呼气试验、白光内镜检查、NBI检查及病理组织学检查(金标准),分析白光内镜检查、NBI联合HP筛查早期胃癌的价值。结果:80例患者经病理诊断胃早期癌性病变率65.00%;HP感染率58.75%。HP感染率在早期胃癌、高级别上皮内瘤变及非癌性病变患者中差异有统计学意义(76.47%vs.61.11%vs.35.71%,P<0.05);胃早期癌性病变筛查中,白光内镜检查与病理结果的一致性中等(Kappa=0.500),NBI检查与病理结果有较高一致性(Kappa=0.738);HP感染者中,白光内镜检查与病理结果一致性较低(Kappa=0.378),NBI检查与病理结果有较高一致性(Kappa=0.667);非HP感染者中,白光内镜检查与病理结果一致性中等(Kappa=0.565),NBI检查与病理结果有较高一致性(Kappa=0.753)。结论:早期胃癌患者HP感染率较高,NBI联合HP感染检查可提高早期胃癌的检出率与准确率。Objective:To explore the diagnostic value of narrow band imaging(NBI)combined with Helicobacter pylori(HP)detection on early gastric cancer.Methods:80 patients with suspected gastric lesions were selected and underwent HP qualitative 13C urea breath test,white light endoscopy,NBI examination and histopathological examination(gold standard)to analyse the value of white light endoscopy and NBI combined with HP detection on early gastric cancer.Results:The rate of early gastric cancerous lesions by pathological diagnosis in 80 patients was 65.00%,the HP infection rate of 80 patients was 58.75%.The HP infection rate was statistically different among patients with early gastric cancer,high-grade intraepithelial neoplasias,and non-cancerous lesions(76.47%vs.61.11%vs.35.71%,P<0.05).In the screening of early gastric cancerous lesions,white light endoscopy had a moderate consistency with pathological result(Kappa=0.500)and NBI had a high consistency with pathological result(Kappa=0.738).For HP-infected patients,white light endoscopy had a general consistency with pathological result(Kappa=0.378),and NBI had a high consistency with pathological result(Kappa=0.667).For non-HP-infected people,white light endoscopy showed a moderate consistency with pathological result(Kappa=0.565),and NBI showed a high consistency with pathological result(Kappa=0.753).Conclusion:The infection rate of HP is higher in patients with early gastric cancer.NBI combined with HP infection detection can enhance the detection rate and accuracy rate of early gastric cancer.

关 键 词：内镜窄带成像 幽门螺杆菌 高危人群 早期胃癌筛查 

分 类 号：R735.2[医药卫生—肿瘤]