窄带成像联合放大胃镜技术在低级别瘤变和早期胃癌中的诊断价值

Diagnostic value of narrow band imaging combined with magnifying endoscopy in low-grade neoplasia and early gastric cancer

目的探讨窄带成像联合放大胃镜(NBI-ME)技术在低级别瘤变和早期胃癌中的诊断价值。方法回顾性分析2013年6月至2017年12月于沧州市人民医院接受检查的192例胃部低级别瘤变及癌前病变患者的临床资料,所有入选患者依次接受白光内镜、NBI-ME检查。比较白光内镜、NBI-ME检查结果与组织学诊断结果的一致性,分析NBI-ME下低级别瘤变及早期癌变与胃小凹Sakaki分型的关系。结果NBI-ME下低级别瘤变与早期癌变诊断准确率均明显高于白光内镜,差异有统计学意义(P<0.05)。在NBI-ME下,胃小凹SakakiⅡ+Ⅲ型与非Ⅱ+Ⅲ型在诊断低级别瘤变上的差异有统计学意义(P<0.05),SakakiⅤ+Ⅵ型与非Ⅴ+Ⅵ型在诊断早期癌变上的差异有统计学意义(P<0.05)。结论相比白光内镜,NBI-ME对低级别瘤变和早期癌变具有更高的诊断效能,结合Sakaki分型可提高低级别瘤变和早期癌变的检出率。

Objective To analyze the diagnostic value of narrow band imaging combined with magnifying endoscopy in low-grade neoplasia and early gastric cancer.Methods A retrospective analysis of 192 cases of low-grade gastric neoplasia and precancerous lesions examined in our hospital from June 2013 to December 2017 was conducted.All the selected patients were examined by white light endoscopy,narrowband imaging combined with magnifying endoscopy(NBI-ME)successively.The consistency between the results of the two endoscopic methods and the histological diagnosis results was compared,and the relationship of Sakaki type of gastric pits and low-grade neoplasia and early gastric cancer under NBI-ME was analyzed.Results Compared with white light endoscopy,the diagnostic accuracy of low-grade neoplasia and early gastric cancer under white light endoscopy combined with NBI-ME was significantly higer,and the difference was statistically significant(P<0.05).Compared with the other types of gastric pits,the diagnostic value of low-grade neoplasia under NBI-ME in Sakaki type Ⅱ and type Ⅲ was statistically significant different(P<0.05).The diagnostic value of early gastric cancer under NBI-ME in Sakaki type Ⅴ and type Ⅵ was statistically significant different to other types of gastric pits(P<0.05).Conclusion Compared with white light endoscopy,NBI-ME has a higher diagnostic efficiency for low-grade neoplasia and early-stage cancer.Combined with Sakaki typing,it can improve the detection rate of low-grade neoplasia and early-stage cancer.