内镜窄带成像(NBI)对癌前病变肠上皮化生的诊断价值

Diagnostic value of endoscopic narrow-band imaging(NBI) in pre-cancerous intestinal metaplasia

目的:探讨内镜窄带成像(NBI)对萎缩性胃炎癌前病变胃肠上皮化生(GIM)的诊断价值。方法:对62例慢性胃炎患者予以内镜常规检查后启动NBI系统,在NBI下如发现淡兰色嵴样结构,在此处取活检,如无此结构就在可疑GIM部位及胃窦前、后壁、大弯、小弯4个部位取活检,并与病理组织学结果进行对照。结果:经病理组织学结果证实,内镜NBI下GIM总检出率为(50/62)80.65%,淡兰色嵴样结构诊断GIM的阳性预测值为91.86%,阴性预测值为84.09%,敏感性为84.95%,特异性为91.36%。结论:内镜窄带成像观察淡兰色嵴样结构是一个GIM高度精确标志,NBI可以提高GIM的检出率,对胃癌的早期诊断及治疗具有重要意义。

Objective：To study the diagnostic value of endoscopic narrow- band imaging （NBI） to atrophic gastritis precancerosis gastric intestinal metaplasia （GIM）. Methods： Sixty two patients were examined by use of a NBI endoscopy, if to discover light blue ridge structure then take biopsy;if no light blue ridge structure biopsy was made in suspicious GIM parts and gastric antrum before and after, lesser curve,greater curve. Results： The endoscopic diagnostic result was compared with pathologic result . Total detection rate of GIM was （50/62） 80.65%. The appearance light blue ridge structure correlated with GIM with sensitivity of 84.95%, specificity of 91.36% ,positive predictive value of 91.86% , negative predictive value of 84.09%. Conclusion ： Endoscopic narrow - band imaging observe the light blue ridge structure is a highly accurate sign of the presence of GIM. NBI can improve the detective rate of GIM. In early diagnosis and treatment of cancer of the stomach is of important significance.