NBI-ME在CEA阳性病例中进行微血管分型诊断胃癌和肠癌的临床价值

The diagnosis value of using NBI-ME in serum CEA positive microvascular parting observation of gastric cancer and colorectal cancer

目的探讨窄带成像放大内镜技术（NBI—ME）在血清癌胚抗原（CEA）阳性病例中进行微血管分型诊断胃癌和肠癌的临床价值。方法搜集2012～2013年在该院检测血清CEA结果为阳性的病例873例，将通过初诊为疑似胃癌的114例和疑似大肠癌的35例患者纳入研究。利用NBIME检查并切取组织进行病理活检。NBI—ME检查重点观察微血管性状并进行分型：规则型、稍不规则型、不规则型、消失型，将微血管分型情况与病理检查结果进行对比。结果病理确诊为癌症13例，检出率为8．72％；上皮内瘤变lO例，检出率为6．71％。规则型和稍不规则型中无癌症病例，在消失型中无非癌性病例。消失型对癌症的灵敏度为100．00％，而不规则型对癌变可能性大的肠化生萎缩和高级别上皮内瘤变的灵敏度为87．50％，差异有统计学意义（P〈0．05）。结论利用NBI—ME观察病变处微血管分型诊断可以帮助在CEA阳性病例中筛查出胃癌和肠癌。

Objective To study clinical diagnosis value of using magnifying endoscopy with narrow-band imaging（NBI-ME） in the CEA positive cases of microvascular parting to gastric cancer and colorectal cancer. Methods 873 cases in our hospital from 2012-2013,who had serum CEA positive were cboosen, the 114 patients who first diagnosis for suspected gastric cancer, 35 pa- tients who first diagnosis forsuspected colorectal cancer were included in this study. Using NBI-ME to check and the pathology bi opsy. NBI ME check key observation microvaseular properties and classification： rules, slightly irregular, irregular, disappeared, the microvascular parting situation compared with pathological findings. Results 13 patients diagnosed with cancer by pathology,the positive rate was 8.72 % ;intraepithelial neoplasia in 10 cases, the positive rate was 6. 71%. No cases of cancer were regular and slightly irregular type,all cancer cases in the disappearance. The sensitivity of type of disappeared was 100. 00% ,and the sensitivity of irregular type of canceration possibility intestinal large atrophy and high grade intraepithelial neoplasia was 87.50%, the differ- ence was statistically significant（P〈0.05）. Conclusion Using NBI ME microvascular classification diagnosis could help observa tion CEA positive cases in the screening of gastric cancer and colorectal cancer.