摘要
目的探讨放大内镜联合窄带成像、醋酸-靛胭脂染色内镜对胃黏膜病变的诊断及应用价值。方法选择2015年9月至2016年12月于芜湖市第二人民医院检查疑似早癌及癌前病变的134例病人依次进行普通白光内镜、窄带成像(NBI)、放大内镜结合窄带成像(ME-NBI)、醋酸-靛胭脂染色内镜、放大内镜联合醋酸-靛胭脂检查,对5种方法的准确性进行比较。结果 134例,共发现150处病变。观察表面微结构方面,ME-NBI(总分503分)与染色放大内镜(总分517分)相似,差异无统计学意义(P>0.05);观察微血管方面,ME-NBI清晰度(总分495分)明显高于染色放大内镜(总分360分),差异有统计学意义(P<0.05);显示病灶轮廓方面,ME-NBI(总分485分)与染色放大内镜(总分473分)相似,染色内镜(总分433分)与NBI(总分456分)相似,差异无统计学意义(P>0.05),均高于普通白光内镜(总分369分),差异有统计学意义(P<0.05);ME-NBI内镜诊断结果与病理结果具有极高一致性,kappa值为0.845,普通白光内镜、窄带成像、ME-NBI、醋酸-靛胭脂染色内镜、放大内镜联合醋酸-靛胭脂诊断准确率分别为80.7%(121/150)、86.7%(130/150)、94.0%(141/150)、87.3%(131/150)、90.0%(135/150),差异有统计学意义(P<0.05),常规白光内镜准确率较低。结论 ME-NBI可以提高早期胃癌及癌前病变的检出率,并为下一步治疗提供指导。
Objective To evaluate the value of magnifying endoscopy combined with NBI,acetic acid added to indigo carmine staining in the diagnosis of gastric mucosal lesion.Methods A total of 134 patients with suspected early gastric cancer were collected from September 2015 to December 2016 in the Second People's Hospital of Wuhu.The lesions were observed under WLE,NBI,ME-NBI,chromoendoscopy,ME-chromoendoscopy.Calculate the specificity,sensitivity,positive predictive value,negative predictive accuracyand consistency of the 5 methods,then compared the accuracy.Results 150 lesions were found in 134 patients.ME-NBI(total score 503)was similar with magnifying chromoendoscopy(total score 517)in observing micro-structure,the difference was not statistically significant(P>0.05);The scores of ME-NBI(total score 495)were higher than that of the magnifying chromo-endoscopy(total score 360)in observing microvascular,the difference was statistically significant(P<0.05);Show the contours of the lesion:ME-NBI(total score 485)was similar with magnifying chromoendoscopy(total score 473),chromoendoscopy(total score 433)was similar with NBI(total score 456),the difference was not statistically significant(P>0.05),were higher than WLE(total score 369),the difference was statistically significant(P<0.05);There was extremely high consistency between endoscopic diagnosis and pathological results with ME-NBI,Kappa value was 0.845.The diagnostic accuracy of WLE,NBI,ME-NBI,chromoendoscopy,ME-chromoendoscopy gastric mucosal lesion was 80.7%(121/150),86.7%(130/150),94.0%(141/150),87.3%(131/150),90.0%(135/150),respectively,the difference was statistically significant(P<0.05).and the accuracy rate of WLE was low.Conclusion ME-NBI is a useful method for the diagnose of the early gastric cancer.
作者
胡莹
丁百静
李宗先
HU Ying;DING Baijing;LI Zongxian(Department of Gastroenterology,The Second People's Hospital of Wuhu,Wuhu,Anhui 241000,China)
出处
《安徽医药》
CAS
2019年第5期881-884,I0002,共5页
Anhui Medical and Pharmaceutical Journal
关键词
胃肿瘤
胃炎
胃黏膜
胃镜检查
靛卡红
着色剂
醋酸
癌症早期检测
窄带成像
Stomach neoplasms
Gastritis
Gastric mucosa
Gastroscopy
Indigo carmine
Coloring agents
Acetic acid
Early detection of cancer
Narrow band imaging
