内镜下窄带成像技术与碘染色技术诊断早期食管癌及癌前病变的价值比较

Comparison of value of endoscopic narrowband imaging technology versus iodine staining technology in diagnosis of early esophageal cancer and precancerous lesions

目的比较内镜下窄带成像技术与碘染色技术诊断早期食管癌及癌前病变的价值。方法选取2018年2月至2019年10月于郑州大学第一附属医院就诊的疑似早期食管癌及癌前病变患者56例作为研究对象,56例患者均同时予以内镜下窄带成像技术与碘染色进行辅助诊断,将手术病理检查结果/随访确诊结果作为金标准,观察并比较内镜下窄带成像技术、碘染色技术诊断早期食管癌及癌前病变的精准度与特异性。结果56例疑似早期食管癌及癌前病变患者经手术病理检查/随访确诊为早期食管癌及癌前病变42例,内镜下窄带成像技术检测到阳性病变40处,阳性预测值、阴性预测值、灵敏度、特异性分别为85.11%(40/47)、88.89%(8/9)、53.33%(8/15)、97.56%(40/41),碘染色技术检测到阳性病变43处,阳性预测值、阴性预测值、灵敏度、特异性分别为91.49%(43/47)、88.89%(8/9)、66.67%(8/12)、97.73%(43/44)。内镜下窄带成像技术与碘染色技术对早期食管癌及癌前病变的阳性预测值、阴性预测值、灵敏度、特异性比较,差异未见统计学意义(P>0.05)。结论内镜下窄带成像技术以及碘染色技术对早期食管癌及癌前病变的临床检出率均相对较高,二者联合检测可进一步提升早期食管癌及癌前病变的临床检出率。而且窄带成像技术结合放大内镜可通过评价病变特性,对组织病理学结果进行预测,从而提高病灶靶向活检的准确性,并在一定程度上了解病变深度,指导下一步的检查或治疗。

Objective To compare the value of endoscopic narrowband imaging and iodine staining in the diagnosis of early esophageal cancer and precancerous lesions.Methods Fifty-six patients with suspected early esophageal cancer and precancerous lesions who were treated in the First Affiliated Hospital of Zhengzhou University from February 2018 to October 2019 were selected as the research objects.All 56 patients were given endoscopic narrow-band imaging technology and iodine staining for auxiliary diagnosis at the same time.The results of surgical pathology/follow-up diagnosis were taken as the gold standard.The endoscopic narrow-band imaging technology and iodine staining technology in the diagnosis of the accuracy and specificity of early esophageal cancer and precancerous lesions were compared.Results Among the 56 patients suspected of early esophageal cancer and precancerous lesions,42 cases were diagnosed as early esophageal cancer and precancerous lesions by surgical pathological examination/follow-up.Forty positive lesions were detected by endoscopic narrow-band imaging,and the positive predictive value,negative predictive value,sensitivity and specificity were 85.11%(40/47),88.89%(8/9),53.33%(8/15)and 97.56%(40/41),respectively.Forty-three positive lesions were detected by iodine staining,and the positive predictive value and negative predictive value were 91.49%(43/47),88.89%(8/9),66.67%(8/12)and 97.73%(43/44),respectively.There was no significant difference in positive predictive value,negative predictive value,sensitivity and specificity between endoscopic narrow band imaging and iodine staining for early esophageal cancer and precancerous lesions(P>0.05).Conclusions The clinical detection rate of early esophageal cancer and precancerous lesions by endoscopic narrow band imaging technology and iodine staining technology are relatively high,and the combined detection of the two technologies can further improve the clinical detection rate of early esophageal cancer and precancerous lesions.Moreover,narrow band imaging combined with magnifying endoscopy can predict the histopathological results by evaluating the characteristics of lesions,so as to improve the accuracy of targeted biopsy,and to a certain extent,understand the depth of lesions,and guide the next step of examination or treatment.