窄带成像及放大胃镜观察胃小凹形态改变对胃黏膜病变诊断价值的研究

Diagnostic Value of Narrow Band Imaging with Magnifying Endoscopy on Observing Pit Patterns in Gastric Mucosal Lesions

目的研究窄带成像及放大内镜(narrow-band imaging system with magnifying endoscopy,NBI-ME)下胃小凹形态改变对诊断胃黏膜病变及早期胃癌的价值。方法对112例常规胃镜检查发现有局部胃黏膜病变(糜烂、颜色异常、隆起、浅凹陷、粗糙等)的患者,NBI-ME模式观察胃小凹形态,参照Tanaka分型对病变进行判断,同时病变区域取活检进行病理检查。结果窄带成像及放大胃镜观察胃小凹形态改变诊断癌前病变(中-重度肠化、轻-中度异型增生)检出率为39.2%(44/112),诊断早期胃癌的检出率为42.3%(11/26);胃黏膜病变NBI-ME诊断癌前病变(中-重度肠化、轻-中度异型增生)的灵敏度为72.7%,特异度为77.9%,符合率为75.8%;诊断早期胃癌的灵敏度为81.8%,特异度为96.0%,符合率为94.6%。结论窄带成像及放大胃镜观察胃小凹形态能够提高癌前病变及早期胃癌的诊断率。

Objective To explore diagnositic value of narrow-band imaging with magnifying endoscopy on morphological changes of gastric pits in gastric lesions and early gastric cancer.Methods 112 cases with local mucosal lesions including erosion,abnormal color,uplift,shallow depression and rough were recruited in this study.Patterns of gastric pits were observed with NBI-ME model and,the lesion type was determined with reference to Tanaka.Results Using narrow band imaging and magnifying endoscopy,the detecting rate gastric precancerous lesions including severe intestinal metaplasia and mild-moderate dysplasia was 39.2%(44/112) and the detecting rate of early gastric cancer was,42.3%(11/26).Conclusion Narrow band imaging and magnifying endoscopy can improve the detecting rate of precancerous lesions and early gastric cancer.