摘要
目的探讨放大内镜结合窄带成像(ME-NBI)与放大内镜智能分光比色技术(ME-FICE)在消化道早期癌变中的诊断价值。方法选择2016年6月至2018年7月焦作煤业集团有限责任公司中央医院收治的337例疑似早期消化道癌患者作为研究对象,均经胃镜和病理组织学检查,其中175例行ME-NBI检查,162例行ME-FICE检查。分析2种诊断方式的诊断结果与病理学诊断结果的一致性,比较2种诊断方式诊断早期胃癌、食管癌、大肠癌中的敏感度和特异度,并采用受试者操作特征(ROC)曲线分析2种诊断方式的诊断效能。结果以病理学诊断结果为金标准,ME-NBI诊断早期胃癌、食管癌、大肠癌的符合率分别为88.00%(44/50)、84.21%(48/57)、92.65%(63/68),Kappa值分别为0.754、0.679、0.849,ME-NBI对早期胃癌、大肠癌的诊断与病理学诊断结果一致性较高。ME-FICE诊断早期胃癌、食管癌、大肠癌的符合率分别为93.48%(43/46)、77.36%(41/53)、87.30%(55/63),Kappa值分别为0.864、0.550、0.733,ME-FICE对早期胃癌的诊断与病理学诊断结果一致性较高。ME-NBI诊断早期胃癌、食管癌、大肠癌的敏感度分别为85.71%(18/21)、86.96%(20/23)、89.66%(26/29),特异度分别为89.66%(26/29)、82.35%(28/34)、94.87%(37/39);ME-FICE诊断早期胃癌、食管癌、大肠癌的敏感度分别为94.44%(17/18)、94.12%(16/17)、74.07%(20/27),特异度分别为92.86%(26/28)、69.44%(25/36)、97.22%(35/36);ME-NBI与ME-FICE诊断早期胃癌、食管癌、大肠癌的敏感度及特异度比较差异无统计学意义(P>0.05)。ME-NBI诊断早期胃癌、食管癌、大肠癌的曲线下面积(AUC)分别为0.877、0.836、0.927,ME-FICE诊断早期胃癌、食管癌、大肠癌的AUC分别为0.929、0.777、0.893。结论ME-NBI和ME-FICE对早期胃癌、食管癌、大肠癌均有较高的诊断准确率,其中ME-NBI更适用于大肠癌、食管癌的诊断,而ME-FICE则更适用于胃癌的诊断。
Objective To investigate the diagnostic value of magnifying endoscopy with narrow-band imaging(ME-NBI) and magnifying endoscopy with fuji intelligent chromoendoscopy(ME-FICE) in early gastrointestinal cancer. Methods A total of 337 patients with suspected early gastrointestinal cancer admitted to the Central Hospital of Jiaozuo Coal Industry Group Limited-liability Company from June 2016 to July 2018 were selected as the study subjects.All patients were confirmed by gastroscopy and histopathologic examination.Among the patients,175 cases were examined by ME-NBI and 162 cases were examined by ME-FICE.The consistency between the diagnostic results of the two diagnostic methods and pathological diagnosis was analyzed.The sensitivity and specificity of the two diagnostic methods for early gastric cancer,esophageal cancer and colorectal cancer were compared.The diagnostic efficacy of the two diagnostic methods was analyzed by receiver operating characteristic (ROC) curve. Results Taking the pathological diagnosis as the gold standard,the coincidence rates of ME-NBI in the diagnosis of early gastric cancer,esophageal cancer and colorectal cancer were 88.00%(44/50),84.21%(48/57) and 92.65%(63/68);and the Kappa values were 0.754,0.679 and 0.849,respectively.ME-NBI had high consistency with pathological diagnosis of early gastric cancer and colorectal cancer.The coincidence rates of ME-FICE in the diagnosis of early gastric cancer,esophageal cancer and colorectal cancer were 93.48%(43/46),77.36%(41/53),87.30%(55/63),respectively;and the Kappa values were 0.864,0.550 and 0.733,respectively.ME-FICE had high consistency with pathological diagnosis in the diagnosis of early gastric cancer.The sensitivity of ME-NBI in the diagnosis of early gastric cancer,esophageal cancer and colorectal cancer was 85.71%(18/21),86.96%(20/23) and 89.66%(26/29);and the specificity was 89.66%(26/29),82.35%(28/34) and 94.87%(37/39),respectively.The sensitivity of ME-FICE in the diagnosis of early gastric cancer,esophageal cancer and colorectal cancer was 94.44%(17/18),94.12%(16/17) and 74.07%(20/27);and the specificity was 92.86%(26/28),69.44%(25/36) and 97.22%(35/36),respectively.There was no significant difference in sensitivity and specificity between ME-NBI and ME-FICE in the diagnosis of early gastric cancer,esophageal cancer and colorectal cancer ( P >0.05).The area under curve (AUC) of ME-NBI in the diagnosis of early gastric cancer,esophageal cancer and colorectal cancer was 0.877,0.836 and 0.927,respectively.The AUC of ME-FICE in the diagnosis of early gastric cancer,esophageal cancer and colorectal cancer was 0.929,0.777 and 0.893,respectively. Conclusion ME-NBI and ME-FICE have high diagnostic accuracy for early gastric cancer,esophageal cancer and colorectal cancer.ME-NBI is more suitable for the diagnosis of colorectal cancer and esophageal cancer,while ME-FICE is more suitable for the diagnosis of gastric cancer.
作者
王中良
许贺春
白洁
WANG Zhong-liang;XU He-chun;BAI Jie(Department of Endoscopic Room of Gastroenterology,the Central Hospital of Jiaozuo Coal Industry Group Limited-liability Company,Jiaozuo 454000,Henan Province,China;Department of Clinical Laboratory,the Central Hospital of Jiaozuo Coal Industry Group Limited-liability Company,Jiaozuo 454000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2019年第9期875-878,882,共5页
Journal of Xinxiang Medical University
关键词
消化道早癌
放大内镜结合窄带成像
放大内镜智能分光比色
诊断价值
early gastrointestinal cancer
magnifying endoscopy with narrow-band imaging
magnifying endoscopy with fuji intelligent chromoendoscopy
diagnostic value
