NBI放大内镜在胃黏膜糜烂鉴别诊断中的价值

Diagnostic Value of Narrow-band Imaging Magnifying Endoscopy in Gastric Erosion Lesions

目的探讨NBI放大内镜在胃黏膜糜烂鉴别诊断中的价值,以及在胃黏膜癌前病变中的诊断价值。方法应用NBI电子放大内镜,对310例患者的胃黏膜糜烂灶进行细微结构形态学观察,并与观察部位活检所得的病理组织学改变进行比较分析。结果胃黏膜糜烂灶处胃小凹形态未见到A型、B型者;365处C型中组织病理均为慢性活动性浅表性炎症;160处D型中,92.5%(148/160)为萎缩性炎症;65处E型中,86.15%(56/65)为肠上皮化生;35处F型中,91.42%(32/35)为异型增生,8.57%(3/30)为肠上皮化生。59例肠上皮化生未发现明显异常增生的毛细血管,而32例异型增生的F型黏膜表面。90.63%(29/32)呈现出不同程度异常增生的毛细血管。与病理组织学比较,NBI放大内镜观察胃黏膜糜烂小凹形态与病理组织学改变呈显著正相关(P<0.01)。结论 NBI放大内镜在胃黏膜糜烂灶性质的判断中有很高的临床应用价值,可应用于胃黏膜癌前病变的普查。

Objective To evaluate diagnostic value of narrow-band imaging magnifying endoscopy in gastric erosive lesions. Methods Microstructures of gastric mucosa in 310 patients with gastric erosion were examined by using narrow-band imaging magnifying endoscopy.And the results of histopathological biopsy taken from gastric erosion were regarded as the gold standard.Results In type E mucosa,86.15%（56/65） suggested intestinal metaplasia,and type F indicated existence of dysplasia of variable degree in 91.42%（32/35） cases,and 8.57%（3/30） cases suggested intestinal metaplasia,and 90.63% （29/32） type F with abnormal hyperplasia blood capillary suggested dysplasia.There were significant difference between them （P0.01 ）.Conclusion Types of gastric pits could be accurately and effectively identified under narrow-band imaging magnifying endoscopy in gastric erosive lesions and identificantion of type E and F would facilitate the diagnosis of such gastric premalignant lesions as intestinal metaplasia and dysplasia.