超声内镜ME-NBI及碘染色技术在早期食管癌浸润深度评估中的应用

Application of endoscopic ultrasonography, ME-NBI and iodine staining in the evaluation of the depth of invasion in early esophageal cancer

目的 探讨超声内镜与放大内镜-窄带成像及碘染色在早期食管癌浸润深度评估中的应用。方法 对72例早期食管癌患者行超声内镜、放大内镜-窄带成像及碘染色检查。术后对病理组织进行活检,判断食管癌浸润深度。将病理结果作为金标准,分析超声内镜与放大内镜-窄带成像及碘染色检查结果判断早期食管癌浸润深度的准确性。结果 病理结果提示入组患者中,M1期~M2期38例(52.78%),M3期~SM1期22例(30.56%),SM2期及其以上12例(16.67%)。超声内镜、放大内镜-窄带成像及碘染色分别检出M1期~M2期30例(41.67%)、32例(44.44%)、32例(47.22%),检出M3期~SM1期27例(37.50%)、25例(34.72%)、25例(34.72%),检出SM2期及以上15例(20.83%)、15例(20.83%)、13例(18.06%),检测准确率分别为76.39%(55/72)、84.72%(61/72)、81.94%(59/72)。超声内镜、放大内镜-窄带成像及碘染色检测结果准确率比较差异无统计学意义(P>0.05),3种方法单独检测准确率均显著低于联合检测(P<0.05或0.01),3种方法联合检测结果与病理结果一致性较高(Kappa=0.931)。结论 超声内镜、放大内镜-窄带成像及碘染色联合检测评估早期食管癌病灶浸润深度的准确性较高,可以为临床治疗提供依据,值得推广应用。

Objective To investigate the application of endoscopic ultrasonography(EUS),magnifying endoscopy with narrow band imaging(ME-NBI)and iodine staining in the evaluation of the depth of invasion in early esophageal cancer.Methods A total of 72 patients with early esophageal cancer were examined by EUS,ME-NBI and iodine staining.Biopsy was performed on the pathological tissue after operation to determine the depth of esophageal cancer invasion.Taking the pathological results as the gold standard,the accuracy of EUS,ME-NBI and iodine staining in judging the depth of invasion of early esophageal cancer was analyzed.Results Pathological results showed that among the enrolled patients,there were 38 cases(52.78%)in M1-M2 stage,22 cases(30.56%)in M3-SM1 stage,and 12 cases(16.67%)in SM2 stage and above.EUS,ME-NBI and iodine staining detected 30 cases(41.67%),32 cases(44.44%),32 cases(47.22%)in M1-M2 stage,27 cases(37.50%),25 cases(34.72%),25 cases(34.72%)in M3-SM1 stage,15 cases(20.83%),15 cases(20.83%),13 cases(18.06%)in SM2 stage and above.The detection accuracy was 76.39%(55/72),84.72%(61/72)and 81.94%(59/72)respectively.There was no significant difference in the accuracy of EUS,ME-NBI and iodine standing(P>0.05).The detection accuracy of the three methods alone was significantly lower than that of the combined detection(P<0.05 or 0.01).The results of the combined detection of the three methods were highly consistent with the pathological results(Kappa=0.931).Conclusions The combined detection of EUS,ME-NBI and iodine standing has high accuracy in evaluating the depth of invasion of early esophageal cancer lesions,which can provide a basis for clinical treatment and is worthy of popularization and application.