放大内镜联合窄带成像在胃部早期肿瘤性病变患者中的应用效果

发布时间：2018-11-26 17:48

【摘要】：目的探讨放大内镜联合窄带成像(ME-NBI)在胃部早期肿瘤性病变患者中的应用效果。方法选取2013年1月-2016年6月于该院消化内镜中心行内镜检查的151例可疑胃早癌患者为研究对象,所有患者先行普通白光内镜(WLE)检查,然后行ME-NBI检查和靶向活检,重点测量腺管间质距离(以下简称腺间距),根据病理结果分为早癌组[高级别上皮内瘤变(HGIN)、黏膜内癌、黏膜下癌,n=72]和非早癌组[低级别上皮内瘤变(LGIN),n=79]。比较两组的基线资料和ME-NBI征象,采用受试者工作曲线下面积(AUC)来评价其对胃早癌的诊断价值。结果早癌组的边界线、不规则的黏膜微血管、不规则的表面腺管和腺间距升高的发生率明显高于非早癌组,差异有统计学意义(P0.05)。ME-NBI对胃早癌的AUC为0.947,高于WLE的0.832,具有较高的诊断价值,其灵敏度(Se)、特异度(Sp)、阳性预测值(PPV)、阴性预测值(NPV)和Youden指数分别为97.2%、84.8%、85.4%、97.1%和0.820。腺间距对胃早癌的AUC为0.907,高于传统微血管纹理与表面结构(VS)分型的0.889,且VS分型与腺间距进行联合诊断的AUC达到0.933,其Se、Sp、PPV、NPV和Youden指数分别为95.8%、83.5%、84.1%、95.7%和0.794。结论 ME-NBI是胃早癌的重要诊断方法,腺间距具有客观性强、简便易行和可重复性好的优点,能辅助传统VS分型来判断病变性质。
[Abstract]:Objective to evaluate the effect of magnifying endoscopy combined with narrow band imaging (ME-NBI) in patients with early gastric neoplasms. Methods 151 patients with suspected early gastric cancer who underwent endoscopy from January 2013 to June 2016 were selected as study subjects. All patients were examined by ordinary white light endoscopy (WLE), then by ME-NBI and targeted biopsy. The interstitial distance of glandular tubules (hereinafter referred to as glandular spacing) was measured and divided into early carcinoma group [high grade intraepithelial neoplasia (HGIN), intramucosal carcinoma, submucosal carcinoma, nongma 72] and non-early carcinoma group [low grade intraepithelial neoplasia (LGIN), nm79] according to pathological results. The baseline data and ME-NBI signs were compared between the two groups. The area (AUC) under the operating curve was used to evaluate the diagnostic value of the two groups for early gastric carcinoma. Results the incidence of increased border, irregular mucosal microvessels, irregular surface glandular tube and glandular spacing in early cancer group was significantly higher than that in non-early cancer group (P0.05). The AUC of ME-NBI for gastric early carcinoma was 0.947. The sensitivity of (Sp), positive predictive value of (Se), specificity was higher than that of WLE 0.832. The predictive value of (PPV), negative predictive value and Youden index of (PPV), negative predictive value were 97.2% and 84.8%, respectively. 97.1% and 0.820%. The AUC of glandular spacing for early gastric carcinoma was 0.907, which was higher than that of traditional microvascular texture and surface structure (VS) typing. The AUC of VS classification combined with glandular spacing was 0.933, and its Se,Sp,PPV, was higher than that of traditional microvascular texture and surface structure (VS) typing. The NPV and Youden indexes were 95.83.5and 84.1percent, respectively. Conclusion ME-NBI is an important method for the diagnosis of early gastric carcinoma. The interglandular spacing has the advantages of objectivity, simplicity and reproducibility. It can assist the traditional VS classification to judge the nature of the lesions.
【作者单位】：浙江省丽水市中心医院体检中心;浙江省丽水市中心医院门诊部;浙江省丽水市中心医院消化内科;
【分类号】：R735.2

【相似文献】