窄带成像放大内镜联合超声微探头对诊断早期食管癌及癌前病变的临床价值

Clinical Value on Diagnosis of Early Esophageal Cancer and Precancerous Lesion by Narrow Band Imaging Magnifying Endoscopy Combined with Miniature Ultrasonic Probe at High Altitude Area

目的:研究窄带成像放大内镜(NBI-ME)联合超声微探头对早期食管癌及癌前病变的诊断价值。方法:选取2014年3月—2017年12月我院普通白光胃镜检查存在食管可疑病变(食管黏膜局限性充血、粗糙不平、浅表糜烂、微隆起、小结节等)患者170例,随机分为两组,各组85例。A组行普通白光内镜检查,B组除普通白光内镜检查外,行窄带成像放大内镜联合超声微探头进行检查。所有病变部位均取活检,以病理结果为诊断的金标准。比较两组检查的灵敏度、特异度、准确度。结果:A组对早期食管癌及癌前病变的灵敏度、特异度、准确度分别为33.3%、51.6%;90.4%、77.9%;86.6%、68.8%;B组对早期食管癌及癌前病变的灵敏度、特异度、准确率分别为100.0%、89.3%;95.0%、93.8%;95.5%、90.1%;B组对早期食管癌及癌前病变的灵敏度、特异度、准确度均高于A组。结论:高海拔地区应用窄带成像放大内镜联合超声微探头能够更清晰更快捷地显示早期食管癌及癌前病变的部位和范围,有助于进行更准确的活检,进而更早、更准确地诊断出早期食管癌及癌前病变,可提高高海拔地区早期食管癌及癌前病变的检出率,对早期食管癌及癌前病变有较高的诊断价值,值得临床推广应用。

Objective：This study is aimed to evaluate the value of diagnosis of early esophageal cancer and precancerous lesion by narrow band imaging magnifying endoscopy combined with miniature ultrasonic probe at Xining area.Methods：170 patients who suffered esophageal lesion（localized congestion of esophageal mucosa,rough and unequal,superficial erosion,microumbones,nodule,etc）were diagnosed with general white gastro scope in The First Hospital of Xining from March in 2014 to December in 2017.Then they were divided into A and B groups with 85 patients for each group.Patients in group A were detected with general white gastro scope only and besides general white gastro scope,group B were performed through narrow band imaging magnifying endoscopy combined with miniature ultrasonic probe.Biopsy was performed for all patients,the pathological results of which were standard to diagnose.Then we compared their sensitivity,specificity and accuracy between two groups.Results：Sensitivity,specificity and accuracy of esophageal cancer and precancerous lesion in group A are 33.3%,51.6%,90.4%,77.9%,86.6% and 68.8%,which are 100.0%,89.3%,95.0%,93.8%,95.5% and 90.1%in group B.Conclusions：Narrow band imaging magnifying endoscopy combined with miniature ultrasonic probe can promptly detect the location and the scope of early esophageal cancer and precancerous lesion clearly,which can help for biopsy to diagnose early esophageal cancer and precancerous lesion and improve detection rate of early esophageal cancer and precancerous lesion at high altitude area.