早期胃癌和上皮内瘤变在放大内镜窄带成像技术下的表现OACSTPCD
Research on manifestations of early gastric cancer and intraepithelial neoplasia under magnifying endoscopy with narrow-band imaging
目的 研究放大内镜窄带成像技术(ME-NBI)在早期胃癌和上皮内瘤变中的诊断效能,以及相关病变的ME-NBI下表现.方法 回顾性分析131例早期胃癌和上皮内瘤变病例的临床资料.分析病变的ME-NBI下表现,比较ME-NBI和白光内镜(WLI)+活检两种方法在早期胃癌和上皮内瘤变中的诊断效能.研究不同程度病变的ME-NBI下表现.结果 ME-NBI诊断早期胃癌、高级别上皮内瘤变(HGIN)和低级别上皮内瘤变(LGIN)的诊断准确率分别为77.96%、77.96%和77.96%;WLI+活检诊断以上病变的准确率分别为60.53%、58.47%和69.70%,两种检查方法诊断LGIN的准确率比较,差异无统计学意义(P>0.05),两种检查方法诊断早期胃癌和HGIN的准确率比较,差异有统计学意义(P<0.05).在LGIN中,脑回样腺管出现率最高,为60.46%.乳头状腺管和绒毛状腺管在LGIN和早期胃癌中出现率较高,分别为57.14%和52.00%.结论 ME-NBI诊断早期胃癌准确率较WLI+活检高.边界线在分化型早期胃癌和上皮内瘤变中有较高的敏感性.绒毛状和乳头状微腺管结构在早期胃癌中出现率更高.脑回状微腺管在LGIN中出现率明显高于其他病变组.
Objective To study the diagnostic efficacy of magnifying endoscopy with narrow-band imaging(ME-NBI)in the diagnosis of early gastric cancer and intraepithelial neoplasia,and their manifestations under ME-NBI.Methods In this retrospective research,we enrolled 131 cases of early gastric cancer and intraepithelial neoplasia.Then analyze the ME-NBI manifestations of lesions,compare the diagnostic efficacy of ME-NBI and white light endoscopy(WLI)+biopsy methods in early gastric cancer and intraepithelial neoplasia and study the ME-NBI manifestations of different degrees of lesions.Results The diagnostic accuracy of ME-NBI for diagnosing early gastric cancer,high grade intraepithelial neoplasia(HGIN)and low grade intraepithelial neoplasia(LGIN)was 77.96%,77.96%and 77.96%,respectively.The diagnostic accuracy of WLI+biopsy for above lesions was 60.53%,58.47%and 69.70%,respectively.There was no statistically significant difference in the accuracy of two diagnostic methods for LGIN(P>0.05),while there was a statistically significant difference in the accuracy of two diagnostic methods for early gastric cancer and HGIN(P<0.05).In LGIN,the highest rate of cerebral gyrus glandular duct emergence was 60.46%.The incidence of papillary and villous ducts is highest in HGIN and early gastric cancer,with rates of 57.14%and 52.00%,respectively.Conclusion ME-NBI has more diagnostic efficiency in early gastric cancer than WLI+biopsy.The demarcation line has better sensitivity in differentiated early gastric cancer and intraepithelial neoplasia.Micro-surface tube like villous,papillary structures has higher occurrence rates in early gastric cancer.The cerebral gyrus microglandular duct appeares significantly higher in LGIN than other groups.
朱亚男;王军;王娟;马欣;吴克俭
徐州医科大学附属医院 消化内科,江苏 徐州 221000
临床医学
窄带成像放大内镜(ME-NBI)早期胃癌上皮内瘤变白光内镜(WLI)诊断效率
magnifying endoscopy with narrow-band imaging(ME-NBI)early gastric cancerintraepithelial neoplasiawhite light imaing(WLI)diagnostic efficiency
《中国内镜杂志》 2024 (007)
56-62 / 7
徐州市重点研发计划(No:KC17185)
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