窄带双变焦放大内镜诊断早期胃癌的研究

The Study of Narrow Band Double Zoom Magnification Endoscopy in the Diagnosis of Early Gastric Cance

目的探讨窄带双变焦放大内镜(Bifocal NBI-ME)对早期胃癌的诊断价值。方法选取2016年3月至2017年8月因上消化道症状行胃镜检查者,共300例,年龄≥40岁。采用自身对照,对病例先行白光内镜检查,记录诊断信息(A组)。再由另外一名医师采用窄带放大模式进行观察,应用VS分型标准进行诊断,记录诊断信息(B组),并对病变取活检行病理检查。计算并比较两组的灵敏度等指标。结果白光内镜诊断早期胃癌的灵敏度、特异度、阳性预测值、阴性预测值、符合率分别为46. 7%(7/15)、96. 5%(275/285)、41. 2%(7/17)、97. 2%(275/283)、94. 0%(282/300)。窄带双变焦放大内镜对于早期胃癌诊断的灵敏度、特异度、阳性预测值、阴性预测值、符合率分别为86. 7%(13/15)、97. 9%(279/285)、68. 4%(13/19)、99. 3%(279/281)、97. 3%(292/300)。两组比较,灵敏度差异有统计学意义(x^2=5. 4,P<0. 05)。结论窄带双变焦放大内镜对早期胃癌的诊断具有较强优势,具有良好临床应用价值。

Objective To explore the diagnostic value of narrow band double zoom magnification endoscopy（ Bifocal NBI-ME） in early gastric cancer.Methods From March 2016 to August 2017,a total of 300 patients,aged 40 or older,examined by gastroscopy due to symptoms of upper digestive tract were selected as the subjects.White light endoscopy was used to record diagnostic information（ group A） by self-control.The other physician used narrow-band amplification mode to observe patients,using vs classification criteria to diagnose,to record diagnostic information（ group B）,and to take biopsy for pathological examination.Indexes such as sensitivity were calculated and compared between the two groups.Results The sensitivity,specificity,positive predictive value,negative predictive value and coincidence rate of white light endoscopy in the diagnosis of early gastric cancer were46. 7%（ 7/15） 、96. 5%（ 275/285） 、41. 2%（ 7/17） 、97. 2%（ 275/283） 、94. 0%（ 282/300）,respectively.The sensitivity,specificity,positive predictive value,negative predictive value and coincidence rate of narrow band double zoom magnification endoscopy in the diagnosis of early gastric cancer were 86. 7%（ 13/15） 、97. 9%（ 279/285） 、68. 4%（ 13/19） 、99. 3%（ 279/281） 、97. 3%（ 292/300）,respectively.The difference of sensitivity between the two groups is statistically significant（χ^2 = 5. 4,P〈0.05）.Conclusion Bifocal NBI-ME has strong advantages in the diagnosis of early gastric cancer and it has good clinical application value.