内镜窄带成像技术诊断早期胃癌及癌前病变的价值研究

The value of endoscopic narrow-band imaging technique in the diagnosis of early gastric cancer and precancerous lesions

目的分析早期胃癌和癌前病变诊断中内镜窄带成像技术的应用效果。方法选取该院消化内科收治的反复性上消化道症状病史的患者300例作为研究对象,对胃黏膜存在可疑病变的区域采用窄带成像联合放大内镜进行靛胭脂染色,在病变活动区域获取活检标本进行病理组织学检查。结果微血管形态和病变轮廓方面NBI效果最佳,胃小凹形态NBI和染色内镜均明显优于普通胃镜,差异有统计学意义(P<0.05);病理学诊断早期胃癌12例,轻度异型增生32例,中度异型增生16例,重度异型增生7例。从NBI模式下可观察到6种胃小凹形态,其中早期胃癌的临床表现为胃小凹Ⅵ型,异型增生则主要表现为胃小凹Ⅴ、Ⅳ型。结论利用内镜窄带成像技术与放大技术能将癌前病变、早期胃癌及时发现,能将病理检查阳性率提高,值得推广应用。

Objective To analyze the application effect of endoscopic narrow-band imaging technique in the diagnosis of early gastric cancer and precancerous lesions.Methods In our hospital,300 patients with recurrent upper gastrointestinal symptoms were selected as the research objects.The areas with suspected gastric mucosa lesions were stained with indigo carmine by narrow-band imaging combined with magnifying endoscopy.Biopsy samples were obtained from the active areas of the lesions and examined by histopathology.Results The results of pathological diagnosis showed that there were 12 patients with early gastric cancer,32 with mild dysplasia,16 with moderate dysplasia and 7 with severe dysplasia.Six types of fovea were observed in NBI model,among which the clinical manifestations of early gastric cancer were foveaⅥand dysplasia were foveaⅤandⅣ.Conclusion The use of endoscopic narrow-band imaging technology and amplification technology can detect precancerous lesions and early gastric cancer in time,which can improve the positive rate of pathological examination,which is worthy of promotion.