窄带成像技术在幽门螺杆菌感染胃早期癌变诊断中的价值  

Application value of endoscopic narrow-band imaging technology in the diagnosis of early gastric cancer under the background of Hp infection

作　　者：李芳芳 刘晓红 孙燕滨 Li Fangfang;Liu Xiaohong;Sun Yanbin(Department of Gastroenterology,Jiaozhou Central Hospital of Qingdao,Jiaozhou 266300,China)

机构地区：[1]青岛市胶州中心医院消化内科,山东省266300

出　　处：《中华消化病与影像杂志(电子版)》2025年第1期29-33,共5页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：2022年度青岛市胶州中心医院科研项目。

摘　　要：目的研究幽门螺杆菌(Hp)感染背景下的内镜窄带成像技术(NBI)在胃早期癌性病变诊断中的应用价值。方法回顾性选择2022年1月至2022年12月青岛市胶州中心医院收治的82例胃早期癌变患者,按照Hp检测结果分为Hp感染组(n=54)与Hp根除组(n=28),所有患者均接受白光内镜及NBI检查,对比Hp感染组与Hp根除组胃早期癌变患者的白光内镜及NBI表现,对比白光内镜及NBI的图像质量评分,绘制受试者工作曲线(ROC)分析内镜对Hp根除胃早期癌变的诊断价值,对比白光内镜、NBI对不同Hp状态下胃早期癌变患者的诊断结果。结果Hp感染组的白光内镜呈弥散样发红、病变凹陷率均明显高于Hp根除组,而边界不清率低于Hp根除组,差异均有统计学意义(P<0.05),两组边界不规则、萎缩率相比无差异(P>0.05)。Hp感染组患者NBI呈微结构紊乱、微血管紊乱、明显边界线的比例明显高于Hp根除组(P<0.05)。白光内镜及NBI对Hp根除组胃早期癌变诊断率均低于Hp感染组(P<0.05),NBI对2组的胃早期癌变诊断率均高于白光内镜(P<0.05)。NBI的微血管形态、胃小凹形态及病变轮廓评分均明显高于白光内镜(P<0.05)。ROC分析显示,白光内镜、NBI对Hp根除组胃早期癌变的诊断的曲线下面积分别为0.571、0.657,特异度分别为74.41%、90.52%,敏感度分别为78.54%、97.45%。结论NBI能够提高Hp感染背景下胃早期癌变的诊断,Hp根除可影响内镜下对胃早期癌变的诊断。Objective To study the application value of endoscopic narrow-band imaging(NBI)in the diagnosis of early gastric cancer under the background of Helicobacter pylori(Hp)infection.Methods A total of 82 patients with early gastric cancer admitted to Jiaozhou Central Hospital of Qingdao from January 2022 to December 2022 were retrospectively selected and divided into Hp infection group(n=54)and Hp eradication group(n=28)according to Hp detection results.All patients underwent white light endoscopy and NBI examination,the white light endoscopy and NBI findings of patients with early gastric cancer in Hp infection group and Hp eradication group were compared,the image quality scores of white light endoscope and NBI were compared,the receiver's working curve(ROC)was drawn to analyze the diagnostic value of endoscopy in Hp eradicated early gastric cancer,and the diagnostic results of white light endoscopy and NBI in patients with early gastric cancer under different Hp conditions were compared.Results The rates of white light endoscope diffused redness and lesion depression in Hp infection group were significantly higher than those in Hp eradication group,the rate of boundary ambiguity in Hp infection group was significantly lower than that in Hp eradication group,there were statistically significant differences(P<0.05);there were no statistically significant differences in the rates of boundary irregularity and shrinkage between the two groups(P>0.05).The diagnostic rate of early gastric cancer in the Hp eradication group was lower than that in the Hp infection group(P<0.05),and the diagnostic rate of early gastric cancer in the NBI group was higher than that in the white light endoscope group(P<0.05).The microvascular morphology,gastric fovea morphology and lesion contour scores of NBI were significantly higher than those of white light endoscopy(P<0.05).ROC analysis showed that the areas under the curve of white light endoscopy and NBI for the diagnosis of early gastric cancer in the Hp eradication group were 0.571 and

关 键 词：胃 癌变 幽门螺杆菌 窄带成像技术 内镜检查术 诊断价值 

分 类 号：R73[医药卫生—肿瘤]