窄带光成像放大内镜下B_(2)型血管预判浅表性食管鳞状细胞癌浸润深度的准确率及影响因素分析  

Analysis of the accuracy and influencing factors of narrow-band imaging magnification endoscopy in preoperative prediction of the depth of invasion in superficial esophageal squamous cell carcinoma (B_(2) type)

作　　者：陈正彦 杨坤 张然[1] 余海洋[1] 张红娟 刘玮[1] 刘君颖[1] CHEN Zhengyan;YANG Kun;ZHANG Ran;YU Haiyang;ZHANG Hongjuan;LIU Wei;LIU Junying(Digestive Endoscopy Center,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学第一附属医院消化内镜中心,河南郑州450000

出　　处：《胃肠病学和肝病学杂志》2024年第8期953-957,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的 以JES分型为基础,阐述窄带光成像放大内镜下B_(2)型血管对于准确预测浅表性食管鳞状细胞癌(superficial esophageal squamous cell carcinoma, S-ESCC)浸润深度的准确率,并分析其影响因素。方法 回顾性分析2018年1月至2023年4月在河南中医药大学第一附属医院诊断的140例S-ESCC患者。根据术前ME-NBI内镜下的诊断结果,将其分为B_(1)型(84例)、B_(2)型(53例)和B_(3)型(3例)。采用2×2诊断软件统计不同JES分型对S-ESCC的效能。同时,应用Logistic回归和森林图评估B_(2)型血管对于S-ESCC患者过度诊断和诊断不足的原因。结果 研究结果显示,不同JES分型对S-ESCC的诊断效能存在差异。B_(1)、B_(2)、B_(3)型诊断的阳性预测值和准确率分别为88.09%和68.79%、28.30%和67.37%、66.66%和95.37%。在JES分型中,B_(2)型对S-ESCC的诊断效能最低。Logistic回归分析显示,相较于MM/SM1型患者,EP/LPM型患者的小区域B_(2)和B_(2)伴炎性侵蚀的发生率显著升高(P<0.05)。同时,与SM2/SM3型患者相比,MM/SM1型患者的内镜下显著特征的发生率显著降低(P<0.05)。结论 B_(2)型分型对于S-ESCC的诊断效能较低。小区域B_(2)、B_(2)伴炎性侵蚀以及内镜下显著特征是MM/SM1型与其他分型之间的主要区别因素。Objective To elucidate the accuracy and influencing factors of narrow-band imaging magnifying endoscopy-based preoperative prediction of the depth of infiltration in superficial esophageal squamous cell carcinoma(S-ESCC)by using the JES classification system.Methods We retrospectively analyzed 140 patients diagnosed with S-ESCC in our hospital from Jan.2018 to Apr.2023.The patients were categorized into B_(1)(84 cases),B_(2)(53 cases)and B_(3)(3 cases)types based on the preoperative ME-NBI endoscopic diagnosis.The diagnostic efficacy of different JES classifications for S-ESCC was assessed using a 2×2 diagnostic software.Logistic regression and forest plot analysis were employed to evaluate the transitional diagnosis and diagnostic insufficiency associated with the B_(2) vascular type.Results The diagnostic efficacy of different JES classifications for S-ESCC varied.The positive predictive value(PPV)and accuracy for B_(1),B_(2),B_(3) types were 88.09%and 68.79%,28.30%and 67.37%,66.66%and 95.37%,respectively.Among the JES classifications,the diagnostic efficacy was lowest for the B_(2) type.Logistic regression analysis revealed a significant increase in the occurrence of small-area B_(2) and B_(2) with inflammatory erosion in patients with the EP/LPM type compared to those with the MM/SM1 type(P<0.05).Furthermore,the occurrence of significant endoscopic features was significantly lower in patients with the MM/SM1 type compared to those with the SM2/SM3 type(P<0.05).Conclusion The B_(2) vascular type exhibits lower diagnostic efficacy for S-ESCC.Small-area B_(2),B_(2) with inflammatory erosion and significant endoscopic features are the main distinguishing factors between the MM/SM1 type and other types.

关 键 词：窄带光成像放大内镜 B_(2)型血管 浅表性食管鳞状细胞癌 

分 类 号：R735.1[医药卫生—肿瘤]