智能染色内镜联合放大内镜对早期胃癌的诊断价值

Value of flexible spectral imaging color enhancement combined with magnifying endoscopy in diagnosis of early gastric cancer

目的通过研究智能染色内镜(flexible spectral imaging color,FICE)联合放大内镜在早期胃癌中的诊断准确度,探讨其临床应用价值.方法回顾性分析承德医学院附属医院自2015-03/2015-12行胃镜检查怀疑早期胃癌并行FICE下放大观察的内镜图片,根据放大内镜下胃黏膜表面微结构、微血管及有无边界线,制定早期胃癌的内镜诊断标准,通过此标准对胃内病变做出诊断,再与病理比较,得出胃镜诊断早期胃癌的敏感性及特异性.结果共有177例图像进行了回顾性分析,病理诊断为低级别上皮内瘤变26例,高级别上皮内瘤变12例,慢性炎症或萎缩性胃炎或肠上皮化生患者139例,FICE联合放大内镜诊断上皮内瘤变的敏感性为68.4%,特异性为87.8%,Youden指数为56.2%.诊断为早期胃癌的敏感性为75.0%,特异性为100%,Youden指数75.0%.结论根据我们制定的标准,FICE联合放大内镜可提高胃镜诊断早期胃癌的准确性.

AIM To evaluate the value of flexible spectral imaging color enhancement（FICE） combined with magnifying endoscopy in the diagnosis of early gastric cancer.METHODS Patients with suspected early gastric cancer who underwent FICE combined with magnifying endoscopy from March 2015 to December 2015 were retrospectively analyzed.The endoscopic diagnosis criteria for early gastric cancer were made according to the micro structure,microvascular and demarcation line.Finally,the accuracy of FICE combined with magnifying endoscopy for the diagnosis of early gastric cancer was assessed by comparing with pathological results.RESULTS Of 177 lesions that underwent FICE and magnifying endoscopy,26 were pathologically diagnosed as low grade intraepithelial neoplasia,12 as high grade intraepithelial neoplasia,and 139 as non-cancer lesions.The sensitivity,specificity and Youden index of FICE combined with magnifying endoscopy were 68.4%,87.8%and 56.2%for intraepithelial neoplasia,and 75.0%,100%and 75.0%for early gastric cancer,respectively.CONCLUSION FICE combined with magnifying endoscopy can improve the diagnostic accuracy for early gastric cancer.