内镜智能分光比色对诊断早期胃肿瘤的临床研究

The clinical study of the diagnosis of fujinon intelligent chromoendoscopy in early gastric tumor

目的:探讨内镜智能分光比色技术(FICE)在诊断早期胃肿瘤的价值。方法:选择2009年1月至2010年12月共8 231例患者进行常规内镜检查,随机分为A、B两组,其中A组4 356例,B组3 875例,发现新生性病变患者(包括胃溃疡,胃肿瘤或息肉样病变者)入选。A组采用FICE放大技术,B组采用常规染色放大技术对病变进行胃黏膜微结构分型及微血管结构观察,对病变作出诊断,并与病理组织学诊断相比较。结果:A组入选189例,采用FICE放大模式下发现病灶203个,其中不典型增生21个,胃癌16个。B组入选133例,采用常规染色放大技术下发现病灶141个,其中不典型增生14个,胃癌10个。FICE放大内镜与常规染色放大内镜均能显示胃小凹及胃黏膜微血管形态,FICE放大内镜对胃黏膜微血管形态比染色放大内镜显示更清晰,两组不典型增生及胃癌病例的优视率比较差异有统计学意义(P<0.05)。FICE放大内镜对不典型增生及胃癌诊断符合率为94.6%(29/31),染色放大内镜诊断符合率为83.3%(15/19),两组比较差异无统计学意义。结论:FICE放大内镜对不典型增生及胃癌诊断的符合率高,对胃黏膜微血管形态显示更清晰,更易于观察胃小凹及胃黏膜微血管形态,利于指导靶向活检,有良好的临床应用价值。

Objective： To explore the diagnosis value of fujinon intelligent chromoendoscopy （FICE） in early gastric tumor. Methods： Eight thousand two hundred and thirtyone patients who had gastroscopy examination were divided into two groups randomly. Group A had 4 356 patients. Group B had 3 875 patients. The patients were chosen by gastric mucosa lesion （ consist of gastric ulcer, gastric tumor or polypus）. Group A was applied by FICE technique and Group B was applied by magnifying chromoendoscopy technique to observe the pattern of gastric pits and mucosa micrangium. To diagnosis gastric mucosa lesion and compare them with histopathology diagnosis, fur ther analyze the relation of them. Results： Group A 189 patients had 203 focus including 21 atypical hyperplasia focus and 16 gastric tumors. Group B 133 patients had 141 focus including 14 atypical hyperplasia focus and 10 gastric tumors. Both of the FICE technique and magnifying chromoendoscopy technique could clearly display the pattern of gastric pits and mucosa micrangium, however FICE technique is clearer than magnifying chromoendosco py technique. There is significant difference. The coincidence rate of FICE on the pattern of gastric pits and muco sa micrangium is 94. 6% （29/31） and magnifying chromoendoscopy technique is 83.3% （ 15/19 ）, difference between these two techniques. Conclusions： The FICE technique has high coincidence rate of with no diagnose and significant display the pattern of mucosa micrangium. It is easy to apply FICE to observe gastric pits and muco sa micrangium in gastric mucosa lesion beneficial to target biopsy. It has good clinical practical value.