内镜窄带成像技术在不同年龄组中对胃黏膜病变的诊断价值

Diagnostic value of narrow band imaging endoscopy in diagnosis of gastric mucosal lesions at different ages

目的探讨内镜窄带成像技术(narrow band imaging,NBI)在不同年龄组中对胃黏膜病变的诊断价值及差异。方法收集2019年1月至2019年8月于安徽医科大学第四附属医院胃镜室行普通白光内镜检查见有胃黏膜病变的患者共182例,NBI模式下观察胃小凹分型并做内镜下诊断。于病变最明显处取活检病理检查,对NBI下不同年龄组的胃小凹分型与病理结果进行分析。结果胃小凹分型与病理诊断在不同年龄组内比较,差异有统计学意义(P<0.05)。不同年龄组(≥60岁组、50~59岁组、≤49岁组)NBI与内镜活检诊断进行一致性检验的Kappa值分别为0.66、0.54、0.53(P<0.05)。NBI对癌前病变诊断在不同年龄组的灵敏度、特异度、准确率之间的差异无统计学意义(P=0.87);NBI对胃癌诊断在不同年龄组的灵敏度、特异度、准确率之间的差异有统计学意义(P=0.01)。结论NBI对胃黏膜病变,尤其是老年组癌前病变及胃癌的诊断有较高的临床应用价值,NBI可对内镜准确活检提供较大帮助。

Objective To investigate the diagnostic value and differences of narrow band imaging(NBI)endoscopy in diagnosis of gastric mucosal lesions at different ages.Methods 182 patients with gastric mucosal lesions that was diagnosed by routine gastroscopy examination in the Fourth Affiliated Hospital of Anhui Medical University from Jan.2019 to Aug.2019 were examined by NBI endoscopy,and the endoscopic diagnosis was made when the gastric pits were carefully observed.Histopathological examination of biopsy samples were performed in the suspicious lesions of gastric mucosa,and the results were compared and analyzed.Results Gastric pit classiffication and pathologic diagnosis were compared in different age groups,the results were statistically significant(P<0.05).The Kappa values of NBI and endoscopic biopsy in different age groups(≥60 years old group,50-59 years old group,≤49 years old group)were 0.66,0.54 and 0.53,respectively(P<0.05).There was no significant difference in sensitivity,specificity and accuracy of NBI in the diagnosis of precancerous lesions among different age groups(P=0.87).The differences of the sensitivity,specificity and accuracy in diagnosis of gastric cancer with NBI in different age groups were statistically significant(P=0.01).Conclusion NBI endoscopy is of high clinical value in the diagnosis of gastric mucosal lesions,especially precancerous lesions and gastric cancer in the elderly group.NBI can afford great help for accurate endoscopic biopsy.