早期胃癌及癌前病变诊断中内镜窄带成像技术的应用价值分析

Application Value of Narrow Band Imaging in the Diagnosis of Early Gastric Cancer and Precancerous Lesions

目的探讨内镜窄带成像技术(NBI)对早期胃癌及癌前病变的诊断价值。方法分别采用普通内镜、NBI和染色内镜对106例患者进行检查,比较不同内镜观察下病变轮廓、黏膜腺管开口形态及浅表毛细血管结构形态清晰度,并将NBI放大内镜、染色放大内镜诊断癌前病变结果与组织病理学检查结果进行比较。结果 NBI与染色内镜对病变轮廓、黏膜腺管开口形态清晰度均显著高于普通内镜,差异具有统计学意义(P<0.05);NBI对病变浅表毛细血管结构形态清晰度显著高于普通内镜,差异具有统计学意义(P<0.05);NBI与染色内镜对病变轮廓清晰度相似,两者比较,差异无统计学意义(P>0.05);NBI对病变黏膜腺管开口形态和浅表毛细血管结构形态清晰度均显著高于染色内镜,差异具有统计学意义(P<0.05);普通内镜与染色内镜对病变浅表毛细血管结构形态清晰度相似,两者比较,差异无统计学意义(P>0.05);NBI放大内镜与染色放大内镜诊断癌前病变的敏感性、特异性、准确性比较,差异无统计学意义(P>0.05)。结论 NBI诊断早期胃癌及癌前病变清晰度高于普通内镜和染色内镜,敏感性、特异性和准确性较高,对发现和诊断早期胃癌及癌前病变具有重要意义。

Objective To explore the clinical value of narrow band imaging（NBI） in the diagnosis of early gastric cancer and precancerous lesions.Methods 106 cases of patients were tested by endoscopic,NBI,and chromoendoscopy.The outline,mucosal opening shape of the gland,superficial capillary structure form definition of lesions were compared.The sensibility,specificity,accuracy were compared.Results The outline,mucosal opening form definition of the gland of lesions by NBI,chromoendoscopy were higher than endoscopic（P〈0.05）; The superficial capillary structure form definition of lesions by NBI were higher than the endoscopic（P〈0.05）; There had no significant difference in outline sharpness of lesions by NBI and chromoendoscopy（P〈0.05）; The mucosa opening shape of the gland and superficial capillary structure form definition of lesions by NBI were higher than chromoendoscopy（P〈0.05）; There had no significant difference in the superficial capillary structure form definition of lesions by endoscopic and chromoendoscopy（P〈0.05）; There had no significant difference in the sensibility,specificity,accuracy（P〈0.05）.Conclusion NBI for the patients with early gastric cancer and precancerous lesions has high sensibility,specificity,and accuracy,it is of great significance in detection and diagnosis of early gastric cancer and precancerous lesions.