慢性萎缩性胃炎内镜窄带成像下形态学与组织学的比较研究

Comparative study on morphology and histology about the chronic atrophic gastritis narrow-band imaging

目的 探讨慢性萎缩性胃炎（CAG）在内镜窄带成像（NBI）下形态学诊断与组织学诊断的比较,以提高正确诊断率.方法 回顾性分析2011年9月至2012年12月经内镜NBI形态学诊断的100例CAG患者的临床资料,对CAG在内镜NBI下的形态学诊断与组织学诊断结果进行对比分析.结果 100例患者中,经病理组织学诊断94例,伴有轻度异型增生28例,中度异型增生8例,重度异型增生7例.内镜NBI模式下,胃小凹形态分为6种类型,异型增生主要表现为胃小凹Ⅳ型和Ⅴ1型,应警惕Ⅴ1型和Ⅵ型发生恶变的可能;7例重度异型增生,其中2例微血管形态尚规则,另外5例微血管形态不一,可见新生血管.结论 内镜NBI操作简单,放大后可清晰观察到胃小凹及微小血管形态,有助于提高CAG及异型增生的靶向活检准确率.

Objective To compare the morphology and histology about the chronic atrophic gastritis （CAG） narrow-band imaging （NBI）,in order to improve the rate of final diagnosis.Methods The clinical data of 100 CAG patients who diagnosed by NBI from September 2011 to December 2012 were analyzed retrospectively.The morphological diagnosis by NBI and histodiagnosis by endoscopy were compared.Results In 100 patients,94 patients were diagnosed by histodiagnosis among whom 28 patients were with mild dysplasia,8 patients were with moderate dysplasia,7 patients were with severe dysplasia.In the NBI mode,gastric pits were divided into 6 kinds of types,dysplasia mainly expressed for Ⅳ and Ⅴ 1 type.In 7 severe dysplasia patients,2 patients of microvascular morphology were regular,the others were anomalism,and found neovascularization.Conclusions Endoscopic NBI technology has the advantage of simple operation,and can clearly observe the gastric pit and microvascular morphology after amplification.It can help to improve the accuracy rate of CAG and dysplasia targeted biopsy.