智能染色内镜对早期胃癌的诊断价值探讨

Fuji intelligent color enhancement chromoendoscopy for diagnosis of early gastric cancer

目的探讨富士能智能染色内镜（FICE）在早期胃癌中的诊断价值。方法2010年2月至2011年3月经普通胃镜检查后疑似早期胃癌的患者67例，分别行电子放大内镜、FICE染色放大内镜、靛胭脂染色放大内镜检查。对疑似病灶的胃黏膜腺管及微血管形态的清晰程度进行评分比较，并对疑似部位进行靶向活检，比较3种内镜诊断早期胃癌的敏感度、特异度以及与病理组织学的符合率。结果67例患者中，经病理组织学检查诊断为早期胃癌17例。FICE染色放大内镜与电子放大内镜、靛胭脂染色放大内镜在观察腺管结构显示方面差异无统计学意义（P〉0．05）。在观察微血管形态方面，FICE染色放大内镜明显好于电子放大内镜、靛胭脂染色放大内镜（P〈0．05）。在诊断早期胃癌的敏感度、特异度以及与病理组织学的符合率方面，FICE染色放大内镜分别为94．1％（16／17）、98．0％（49／50）、97．0％（65／67），靛胭脂染色放大内镜分别为88．2％（15／17）、96．0％（48／50）、94．0％（63／67），电子放大内镜分别为58．8％（10／17）、84．0％（42／50）、77．6％（52／67），FIEC染色放大内镜均明显高于电子放大内镜（P〈0．05），且均与靛胭脂染色放大内镜相近（P〉0．05）。结论FICE染色放大内镜可以更方便地提供清晰的血管图像，有助于早期胃癌的诊断，提高活检检查的准确率。

Objective To evaluate Fuji intelligent color enhancement （FICE） chromoendoscopy for diagnosis of early gastric cancer. Methods From February 2010 to March 2011, a total of 67 patients with suspected gastric mucosal lesions were enrolled in this study. The lesions were observed with magnifying endoscopy, FICE, magnifying chromoendoscopy and indigo-carmine-magnifying-chromoendoscopy. Suspected gastric mucosal pit patterns and microvascular morphology were compared. Targeted biopsy was performed on suspected locations. Sensitivity, specificity and pathological consistency were compared be- tween the 3 procedures. Results Out of 67 patients, 17 were diagnosed as having early gastric cancer. There was no difference among magnifying endoscopy, FICE magnifying chromoendoscopy and indigo-carmine-magnifying-chromoendoscopy in pit pattern findings, however, FICE magnifying chromoendoscopy was superior to other 2 procedures in displaying capillary loop. The sensibility, specificity and pathological accordance rate of FICE magnifying chromoendoscopy were 94. 1% （16/17）, 98.0% （49/50）and 97.0% （65/67）, which were higher than those of the magnifying endoscopy [ 58.8% （10/17）, 84% （42/50） and 77.6% （52/67） ] （P 〈0. 05）, and were not different from those of indigo-carmine-magnifying-chromoendoscopy [ 88.2% （ 15/17）, 96% （48/50） and 94.0% （63/67） ] （P 〉 0. 05 ）. Conclusion FICE magnifying chromoendoscopy provides rather clear images of gastric mucosa and intrapapillary capillary, thereby improving the accuracy of endoscopic biopsy and then imporving the diagnosis rate of early gastric cancer.