胃黏膜平坦型病变的胃镜及病理表现分析

Gastroscopy and Pathological Manifestations of Gastric Mucosal Flat Lesions

目的 探讨胃黏膜平坦型病变患者的胃镜及病理表现.方法 回顾性分析2015年1月至2016年12月138例胃黏膜平坦型病变患者的临床资料,比较胃镜及病理诊断结果的一致性.结果 138例胃黏膜平坦型病变患者经病理证实,炎性反应65例,低级别上皮内瘤变(LGIN)37例,早期胃癌25例,进展期胃癌11例.病变位于胃窦大于其他部位(P<0.05);胃镜与病理诊断的一致率91.30%,Kappa值为0.883(P<0.05),一致性较好.NBI-ME胃镜对炎性反应、LGIN、早期胃癌和进展期胃癌的诊断符合率分别为96.92%、91.89%、88.00%、81.81%;NBI-ME胃镜对平坦型病变早期胃癌诊断的敏感度、特异度和准确率分别是81.48%、97.29%、94.20%.结论 NBI-ME对胃黏膜平坦型病变中早期胃癌具有较高的诊断价值,值得临床推广应用.

Objective To discuss the pathological performance of gastroscopy in patients with flat gastric mucosa lesion. Methods 138 patients with flat gastric mucosa lesion from Jan 2015 to Dec 2016 in our hospital were retrospectively analyzed. The consistency of gastroscopy and pathologic diagnosis were compared. Results Of 138 patients with flat gastric mucosa lesion,65 cases of inflammatory reaction,25 cases of early gastric cancer, 37 cases of low grade intraepithelial neoplasia,11 cases of advanced gastric cancer were found. The proportion of lesions in the gastric antrum was significantly higher than that in other parts. The consistent rate of gastroscopy and pathological diagnosis was 91.30%. The diagnostic coincidence rates of NBI-ME gastroscopy in inflammatory response,LGIN,early gastric cancer and advanced gastric cancer were 96.92%(63/65),91.89%(34/37), 88.00%(22/25)and 81.81%(9/11). The sensitivity,specificity,and accuracy of NBI-ME gastroscopy in early gastric cancer diagnosis were 81.48% (22/27),97.29%(108/111)and 94.20%(130/138). Conclusion NBI-ME has high diagnostic value for early gastric cancer in flat lesions mucosa lesion and is worthy of clinical application.