蓝光内镜成像模式对胃癌前病变的诊断价值  

Diagnostic Value of Blue Light Endoscopic Imaging Modality for Gastric Precancerous Lesions

作　　者：马瑛泽 MA Yingze(Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报(自然科学版)》2025年第2期221-224,共4页Journal of Beihua University(Natural Science)

基　　金：吉林市科技创新发展计划项目(20210409068)。

摘　　要：目的探讨蓝光成像(blue laser imaging,BLI)与白光成像(white light imaging,WLI)模式对胃癌前病变的诊断差异。方法选取108例有消化道症状患者,在所有患者疑似病变部位均采用以下顺序重点观察:WLI→WLI+ME→BLI→BLI+ME→BLI+ME,并在病灶处取活检。比较WLI模式和BLI模式下病灶轮廓图片清晰度;比较WLI模式+放大内镜(magnifying endoscopy,ME)模式和BLI模式+放大内镜(magnifying endoscopy,ME)模式下观察微血管(microvascular,MV)及微结构(microsurface,MS)图片清晰度;统计BLI+ME模式诊断胃癌前病变的诊断结果、临床诊断价值。结果BLI模式下观察病变轮廓清晰度优于WLI模式(P<0.05),BLI+ME模式观察胃小凹开口形态清晰度优于WLI+ME模式(P<0.05)。BLI+ME模式内镜下诊断慢性萎缩性胃炎的灵敏度为98.9%,特异度为91.4%;BLI+ME模式内镜下诊断胃黏膜肠上皮化生的灵敏度为91.7%,特异度为89.5%;BLI+ME模式观察不典型增生,胃小凹开口分别为C型、D型、E型,3型之间比较差异无统计学意义(P>0.05)。通过BLI+ME模式观察蓝嵴征(light blue crest,LBC)诊断胃黏膜肠上皮化生诊断的灵敏度为87.5%,特异度为83.8%。结论BLI模式较WBI模式可清晰区分病灶与正常黏膜;BLI+ME模式可清晰显示胃部病变的轮廓及MV和MS、LBC等,从而提高胃癌前病变的诊断率,BLI模式对胃癌前病变的内镜诊断更具有临床价值。Exploring the differences between blue laser imaging(BLI)and white light imaging(WLI)modalities for the diagnosis of gastric precancerous lesions.Methods 108 patients with gastrointestinal symptoms were selected,and the following sequence was used to focus on the suspected lesion sites in all patients:WLI→WLI+ME→BLI→BLI+ME→BLI+ME,and biopsies were taken from the lesions.Compare the clarity of lesion contour pictures in WLI mode and BLI mode.Compare the clarity of microvascular(MV)and microsurface(MS)pictures in WLI mode with magnifying endoscopy(ME)and BLI mode with magnifying endoscopy(ME).Evaluate the diagnostic results and clinical diagnostic value of BLI+ME mode for diagnosing precancerous lesions in the stomach.Results The clarity of lesion contour in BLI mode was better observed than that in WLI mode,and the difference was statistically significant(P<0.05).The clarity of the gastric small concave openings in BLI+ME mode was better observed than that in WLI+ME mode,and the difference was statistically significant(P<0.05).The sensitivity of endoscopic diagnosis of chronic atrophic gastritis in BLI+ME mode was 98.9%,and specificity was 91.4%.The sensitivity of endoscopic diagnosis of intestinal epithelial hyperplasia of the gastric mucosa in BLI+ME mode was 91.7%,with a specificity was 89.5%.The observation of atypical hyperplasia in BLI+ME mode showed that the gastric small concave openings were of type C,D,and E respectively.The comparison between the three types was not statistically significant(P>0.05).The sensitivity of diagnosing gastric mucosal intestinal epithelial hyperplasia was 87.5%,and the specificity was 83.8%,as determined by observing the light blue crest(LBC)using the BLI+ME mode.Conclusion BLI mode can clearly distinguish lesions from normal mucosa better than WBI mode.BLI+ME mode can clearly show the contours of gastric lesions,as well as MV,MS,LBC,etc.,thereby improving the diagnostic rate of gastric precancerous lesions.Additionally,BLI mode is more clinically valuable for the endo

关 键 词：蓝光成像技术 胃癌前病变 内镜检查 诊断 

分 类 号：R735.2[医药卫生—肿瘤]