摘要
目的:探究NBI-ME联合染色内镜在早期胃癌及癌前病变中的诊断价值。方法:采用醋酸染色技术、窄带成像+放大内镜(NBI-ME)及上述联合诊断方法对198例胃黏膜可疑病变者进行诊断。以病理学检测作为金标准,比较三种检测手段对早期胃癌及癌前病变的图片质量、诊断一致性及诊断效果。结果:醋酸内镜染色+NBI-ME观察的早期胃癌、癌前病变的图片质量评分均高于醋酸内镜染色及NBI-ME检查手段,差异有统计学意义(P<0.05)。病理组织活检的阳性检出率为44.44%(88/198);醋酸内镜染色的阳性检出率为47.98%(95/198);NBI-ME的阳性检出率为47.98%(95/198);NBI-ME+醋酸内镜染色的阳性检出率为46.46%(92/198)。醋酸内镜染色、NBI-ME及NBI-ME+醋酸内镜染色与病理学诊断均具有较好的一致性(Kappa分别为0.706、0.767、0.878,P<0.001)。NBI-ME+醋酸内镜染色检查的曲线下面积(AUC)、灵敏度、特异度、阳性预测值及阴性预测值均高于NBI-ME及醋酸内镜染色检查(P<0.05)。结论:醋酸内镜染色联合NBI-ME的诊断效果比二者单独使用时高,可提高早期胃癌及癌前病变的检出率。
Objective:To explore the diagnostic value of NBI-ME combined with staining endoscopy in early gastric cancer and precancerous lesions.Methods:A total of 198 patients with suspicious lesions of gastric mucosa were diagnosed by acetic acid staining,narrowband imaging+magnifying endoscopy(NBI-ME)and the combined diagnostic methods mentioned above.The picture quality,diagnostic consistency and diagnostic effect of the above methods for early gastric cancer and precancerous lesions were compared using pathological detection as the gold standard.Results:The image quality scores of early gastric cancer and precancerous lesions observed by acetic endoscopy and NBI-ME were all higher than those by acetic endoscopy and NBI-ME,with statistical significance(P<0.05).Among 198 cases with suspicious gastric mucosa lesions,88 cases were detected positive by pathological biopsy,with a positive detection rate of 44.44%.95 cases were positive by acetic acid endoscopic staining,and the positive detection rate was 47.98%.95 NBI-ME cases were positive,with a positive detection rate of 47.98%.NBI-ME+acetic acid endoscopic staining detected positive cases in 92 cases,the positive detection rate was 46.46%.Acetic acid endoscopic staining,NBI-ME and NBI-ME+acetic acid endoscopic staining showed good consistency with pathological diagnosis of the disease(Kappa=0.706,0.767,0.878,P<0.001).The area under curve(AUC),sensitivity,specificity,positive predictive value and negative predictive value of NBI-ME+acetic endoscopy staining were higher than those of NBI-ME and acetic endoscopy staining(P<0.05).Conclusion:Compared with the two separate diagnoses,endoscopic acetic acid staining combined with NBI-ME can more clearly display the lesions of early gastric cancer and precancerous lesions,and has a good consistency with pathological examination,and higher diagnostic efficiency,which can improve the detection rate of early gastric cancer and precancerous lesions.
作者
蔡勇
赵晓琳
于久飞
CAI Yong;ZHAO Xiao-lin;YU Jiu-fei(Department of Digestive Oncology,Civil Aviation General Hospital,Beijing 100025,China)
出处
《川北医学院学报》
CAS
2021年第10期1314-1318,共5页
Journal of North Sichuan Medical College
基金
北京市民航医学中心科研项目(201938)。
关键词
早期胃癌
癌前病变
NBI-ME
染色内镜
临床病理特征
诊断价值
Early gastric cancer
Precancerous lesions
NBI-ME
Staining endoscopy
Clinicopathologic feature
Diagnostic value
