FICE技术在早期胃癌诊断中的应用及适宜波长选择研究

Research on application of FICE technique in diagnosis of early gastric cancer and selection of suitable wavelengths

目的探讨智能电子分光技术(FICE)在早期胃癌诊断中的应用及适宜波长的选择。方法回顾性分析我院2017年1月~2018年1月胃镜检查发现可疑病灶患者240例,根据检查方式不同分为对照组118例和观察组122例,对照组采用常规内镜检查,观察组采用内镜FICE技术检查,并从观察组中选出图像最为清晰的三组波长组合,分为A组:R=500nm、G=440nm、B=415nm;B组:R=500nm、G=460nm、B=420nm;C组:R=500nm、G=485nm、B=425nm。所有患者均行组织病理学活检。比较对照组和观察组早期胃癌检出率、IMVP和DL检出率,记录观察组腺管开口情况,比较A、B、C组微细腺管开口清晰度。结果观察组患者DL分界、IMVP检出数显著高于对照组(P <0.05);观察组早期胃癌总检出率显著高于对照组(P <0.05);观察组患者慢性炎症主要表现为Ⅰ型、Ⅱ型腺管开口,肠化主要表现为Ⅲ型腺管开口,轻、中度异型增生主要表现为Ⅲ型、Ⅳ型腺管开口,重度异型增生主要表现为Ⅳ型、Ⅴ型腺管开口;针对Ⅰ~Ⅲ型腺管开口,B组与C组、A组与C组清晰率比较差异无统计学意义(P> 0.05),A组清晰率显著低于B组(P <0.05),针对Ⅳ~Ⅴ型腺管开口,A组与B组、B组与C组清晰率比较差异无统计学意义(P> 0.05),A组清晰率显著低于C组(P <0.05)。结论智能电子分光技术用于早期胃癌诊断,能显著提高DL分界、IMVP检出率,提升早期胃癌检出率,选取最佳波长组合实施FICE技术,能成像更清晰,有助辩别腺管开口类型并根据腺管开口类型推测病变组织类型。

Objective To explore the application of Fuji intelligent color enhancement(FICE) in diagnosis of early gastric cancer and the selection of suitable wavelengths. Methods 240 patients with suspicious lesions found by gastroscopy in our hospital from January 2017 to January 2018 were retrospectively analyzed. According to different examination methods, there were divided into the control group with 118 cases and the observation group with 122 cases. The control group was given conventional endoscopy while the observation group was examined by endoscopic FICE technique. The three groups of wavelengths with the clearest image were selected from the observation group and divided into group A: R=500 nm, G=440 nm, B=415 nm;group B: R=500 nm, G=460 nm, B= 420 nm and group C: R=500 nm, G=485 nm, B=425 nm. All patients underwent histopathological biopsy. The detection rate of early gastric cancer, IMVP and DL in the control group and the observation group were compared. The pit pattern of the observation group was recorded and the clarity of the micro pit pattern in group A, B and C was compared. Results The detection number of DL boundaries and IMVP in the observation group was significantly higher than that in the control group(P < 0.05). The total detection rate of early gastric cancer in the observation group was significantly higher than that in the control group(P < 0.05). The chronic inflammation in the observation group mainly showed type Ⅰ and type Ⅱ pit pattern and the intestinal metaplasia mainly showed type Ⅲ pit pattern. The mild and moderate dysplasia mainly showed type Ⅲ and Ⅳ pit pattern and severe dysplasia mainly showed type Ⅳ and Ⅴ pit pattern. For type IV and V pit pattern, there was no significant difference in the clear rate between group B and group C and between group A and group C(P > 0.05). The clarity rate of group A was significantly lower than that of group B(P < 0.05). For type Ⅳ and Ⅴ pit pattern, there was no significant difference in the clear rate between group B and group C and between group A and group C(P > 0.05). The clarity rate of group A was significantly lower than that of group C(P < 0.05). Conclusion Application of Fuji intelligent color enhancement in diagnosis of early gastric cancer can significantly improve detection rates of DL boundaries, IMVP and early gastric cancer. The FICE technique can be used by selecting the best wavelength combination to obtain clearer imaging, thus helping to distinguish the types of pit pattern and to predict the types of lesions according to the types of pit pattern.