放大内镜窄带成像对于胃神经内分泌肿瘤的诊断价值

Diagnostic value of narrow band imaging and magnifying endoscopy in gastric neuroendocrine neoplasms

目的:分析运用白光内镜(WLI)及放大内镜窄带成像(ME-NBI)诊断胃神经内分泌肿瘤(G-NENs)的特点并探讨其临床诊断价值。方法:选择2017年1月-2021年6月西安市人民医院收治的36例G-NENs患者(观察组)及同期收治的40例胃息肉患者(对照组)临床资料,分析观察组临床病理特点及2组病变ME-NBI特点。结果:WLI结合ME-NBI诊断G-NENs敏感性为80.6%,特异性为90.0%,阳性预测值为87.9%,阴性预测值为83.7%,准确度为85.5%,约登指数为0.71。结论:WLI结合ME-NBI有利于观察G-NENs表面特异性的腺体结构改变及上皮下黑棕色迂曲增粗的螺旋状血管,对于鉴别G-NENs及胃息肉有重要意义,能够针对性地对病灶进行靶向活检,避免漏诊及误诊,并对正确治疗方式选择提供帮助。

Objective: To investigate the values of white light imaging combined with magnifying endoscopy and narrow band imaging(ME-NBI) in the diagnose of the gastric neuroendocrine neoplasms(G-NENs). Methods: Clinical data, characteristics of WLI and ME-NBI, pathological and immunehistochemical results of 36 G-NENs patients and 40 gastric polyps patients from January 2017 to June 2021 in our hospital were collected and retrospectively analyzed. Results: WLI combined with ME-NBI diagnosis of G-NENs showed that the sensitivity was 80.6%, the specificity was 90.0%, the positive predictive value was 87.9%, the negative predictive value was 83.7%, the accuracy rating was 85.5% and the Yoden index was 0.71. Conclusion: WLI combined with ME-NBI has been shown to be more effective for targeting biopsy by discovery specific structural changes and dilated blackish-brown subepithelial vessels with cork-screw capillaries on the surface of G-NENs, has a significant clinical value for diagnosis of G-NEN and differentiation diagnosis of gastric polyps, avoid and reduce the rate of misdiagnose and adapts appropriate treatment strategies.