IPCL分类对食管早期肿瘤诊断价值的应用

Application value of IPCL classification in the diagnosis of early esophageal cancer

目的:探讨食管上皮乳头内毛细血管袢(IPCL)分型对食管早期肿瘤的诊断价值。方法:选择接受食管胃镜检查发现疑似食管早期肿瘤的病人100例,随机分为IPCL组和Lugol′s组,各50例。所有病人先行普通白光内镜检查食管后,Lugol′s组病人采用常规的碘染色检查;IPCL组病人采用内镜窄带成像技术结合放大内镜检查;评价2种检查方法对病变组织观察的清晰度,并由操作对病变组织进行IPCL进行分型与病理组织学检查结果进行比较,评价IPCL分类对食管早期肿瘤的敏感度、特异度。结果:2组病人病变位置观察清晰度差异无统计学意义(P>0.05)。2组病人的诊断符合率、对早期食管癌的敏感性、阳性预测值差异均有统计学意义(P<0.05~P<0.01),2组病人的特异性差异无统计学意义(P>0.05);IPCL分类对早期食管癌浸润深度的判断准确率为70.83%。结论:IPCL分类可准确判断病变性质及浸润深度,有助于提高食管早期肿瘤的诊断率,对临床治疗具有重要的指导意义。

Objective:To investigate the diagnostic value of intrapapillary capillary loop(IPCL)classification in early esophageal cancer.Methods:One hundred patients suspected by early esophageal tumors under esophagogastroscopy were randomly divided into the IPCL group and Lugol′s group(50 cases each group).After the esophagus in all patients were detected using routine white-light endoscopy,the Lugol′s group was detected using the routine iodine staining,and the IPCL group was detected using the endoscopic narrow band imaying combined with magnifying endoscopy.The clarity of lesion tissue in two groups was evaluated,the IPCL classification of lesion tissue was compared with the results of histopathological examination,and the sensitivity and specificity of IPCL classification to early esophageal tumor were evaluated.Results:The difference of the clarity of lesion tissue between two groups was not statistically significant(P>0.05),and the differences of the diagnostic coincidence rate,sensitivity to early esophageal cancer and positive predictive value between two groups were statistically significant(P<0.05~P<0.01).The difference of the specificity between two groups was not statistically significant(P>0.05).The accuracy rate of the IPCL classification in the judgement of the depth of invasion of early esophageal cancer was 70.83%.Conclusions:IPCL classification can accurately judge the nature and depth of invasion of esophageal lesion,improve the diagnostic rate of early esophageal tumors,and has important guiding significance for clinical treatment.