窄带成像及碘染色对早期食管癌的筛查价值分析

Screening value of NBI and iodine staining for early esophageal cancer

目的:分析窄带成像(NBI)及碘染色法在早期食管癌筛查中的应用价值。方法:选取235例疑似早期食管癌患者作为研究对象,病理检查前均接受普通内镜、NBI与碘染色检查,比较三种检查方式对早期食管癌的诊断准确性。结果:早期食管癌118处、非早期食管癌130处;普通内镜对早期食管癌诊断灵敏度82.20%、特异度72.31%、准确性77.02%、Kappa值0.54;NBI诊断灵敏度91.53%、特异度86.92%、准确性89.11%、Kappa值0.78;碘染色诊断灵敏度96.61%、特异度95.38%、准确性95.97%、Kappa值0.92;NBI与碘染色诊断早期食管癌灵敏度、特异度及准确性高于普通内镜(P<0.05);碘染色诊断特异度与准确性高于NBI(P<0.05);NBI和碘染色诊断灵敏度无显著差异(P>0.05);NBI与碘染色对高级别上皮内瘤变(HGIN)、早期癌检出率比较无显著差异(P>0.05)。结论:NBI与碘染色方法均对早期食管癌具有较高诊断价值,其中碘染色诊断特异性更高,更有利于LGIN的检出。

Objective:To analyze the application value of narrow band imaging(NBI)and iodine staining in screening early esophageal cancer.Methods:235 patients with suspected early esophageal cancer were elected as the research objects.Before pathological examination,they were examined by ordinary endoscopy,NBI and iodine staining.The diagnostic accuracy of three examination methods for early esophageal cancer was compared.Results:The pathological results showed that there were 118 sites with early esophageal cancer and 130 sites with non-early esophageal cancer.The sensitivity,specificity,accuracy and Kappa value of common endoscopy,NBI and iodine staining for diagnosis of early esophageal cancer were(82.20%,72.31%,77.02%,0.54),(91.53%,86.92%,89.11%,0.78)and(96.61%,95.38%,95.97%,0.92),respectively,The sensitivity,specificity and accuracy of NBI and iodine staining for the diagnosis of early esophageal cancer were significantly higher than those of common endoscopy(P<0.05).The specificity and accuracy of iodine staining were significantly higher than those of NBI(P<0.05),and there was no significant difference in diagnostic sensitivity between the two methods(P>0.05).There were no significant differences in the detection rates of high grade intraepithelial neoplasia(HGIN)and early cancer between NBI and iodine staining(P>0.05).Conclusion:Both NBI and iodine staining are of high diagnostic value for early esophageal cancer.The diagnostic specificity of iodine staining is higher,which is more conducive to LGIN detection.