窄带成像技术联合放大内镜在胃上皮内瘤变及早期胃癌中的应用价值  

Application value of narrow band imaging combined with magnifying endoscopy in gastric intraepithelial neoplasia and early gastric cancer

作　　者：熊欢 蒋丹丹 陈涛[1] 余杨 荆晓娟[1] XIONG Huan;JIANG Dandan;CHEN Tao;YU Yang;JING Xiaojuan(Department of Digestive Endoscopy Center,Suining Central Hospital,Suining 629000,China)

机构地区：[1]遂宁市中心医院消化内镜中心,四川遂宁629000

出　　处：《陕西医学杂志》2024年第11期1517-1520,共4页Shaanxi Medical Journal

基　　金：消化道早癌医师共同成长计划科研立项课题(GTCZ-2020-SC-51-0001)。

摘　　要：目的:探讨窄带成像技术(NBI)联合放大内镜(ME)在胃上皮内瘤变及早期胃癌(EGC)中的应用价值。方法:选取就诊的疑似胃上皮内瘤变及EGC患者108例为研究对象,均接受常规白光内镜检查与NBI-ME检查。比较常规白光内镜与NBI-ME的图像质量评分。以组织病理学结果为金标准,比较白光内镜和NBI-ME诊断胃上皮内瘤变及EGC的准确率。比较胃上皮内瘤变及EGC在NBI-ME下的特征。结果:NBI-ME在病灶轮廓、胃黏膜表层形态、微血管形态方面的图像质量评分均高于常规白光内镜(均P<0.05)。组织病理学检查结果,胃上皮内瘤变60例,EGC48例。白光内镜诊断胃上皮内瘤变46例,EGC 35例,其诊断胃上皮内瘤变准确率为76.67%,诊断EGC准确率为72.92%。NBI-ME诊断胃上皮内瘤变56例,EGC 44例,其诊断胃上皮内瘤变准确率为93.33%,诊断EGC准确率为91.67%。NBI-ME诊断胃上皮内瘤变及EGC的准确率高于白光内镜(均P<0.05)。胃上皮内瘤变与EGC在边界线、不规则表面微结构和黏膜微血管、腺管密度、黏膜微血管密度方面比较差异有统计学意义(均P<0.05)。结论:NBI-ME在胃上皮内瘤变和EGC的诊断中具有较高的应用价值。Objective:To investigate the application value of narrow band imaging(NBI)combined with magnifying endoscopy(ME)in gastric intraepithelial neoplasia and early gastric cancer(EGC).Methods:A total of 108 patients suspected of gastric intraepithelial neoplasia and EGC were selected.All of them underwent white light endoscopy and NBI-ME.Image quality of conventional white light endoscopy and NBI-ME was compared.With histopathologic results as the gold standard,the accuracy rates of white light endoscopy and NBI-ME in diagnosing gastric intraepithelial neoplasia and EGC were compared.The characteristics of gastric intraepithelial neoplasia and EGC under NBI-ME were compared.Results:Image quality scores of NBI-ME were higher than those of conventional white light endoscopy in terms of lesion contour,gastric mucosal surface morphology,and microvascular morphology(all P<0.05).Histopathologic results showed 60 cases with gastric intraepithelial neoplasia and 48 cases with EGC.White light endoscopy diagnosed 46 cases with gastric intraepithelial neoplasia and 35 cases with EGC.The diagnostic accuracy rates for gastric intraepithelial neoplasia and EGC were 76.67%and 72.92%,respectively.NBI-ME diagnosed 56 cases with gastric intraepithelial neoplasia and 44 cases with EGC.The diagnostic accuracy rates for gastric intraepithelial neoplasia and EGC were 93.33%and 91.67%,respectively.The accuracy rates of NBI-ME in diagnosing gastric intraepithelial neoplasia and EGC were higher than those of white light endoscopy(all P<0.05).There were significant differences between gastric intraepithelial neoplasia and EGC in terms of boundary line,irregular surface microstructure,irregular mucosal microvessels,glandular duct density,and mucosal microvessel density(all P<0.05).Conclusion:NBI-ME has relatively high application value in the diagnosis of gastric intraepithelial neoplasia and EGC.

关 键 词：早期胃癌 胃上皮内瘤变 窄带成像技术 放大内镜 应用价值 

分 类 号：R735.2[医药卫生—肿瘤]