窄带成像—放大内镜在上消化道早期癌及癌前病变筛查中的应用

Application of magnifying endoscopy with narrow-band imaging in the screening of early carcinoma and precancerous lesions of upper gastrointestinal tract

目的 评价窄带成像—放大内镜(M-NBI)在人群机会性筛查中对上消化道早期癌及癌前病变的诊断价值。方法 选取2018年8~10月在我院消化内镜中心接受上消化道内镜检查的患者作为研究对象。将使用M-NBI检查的患者纳入M-NBI组,使用白光—非放大内镜(C-WLI)检查的患者纳入C-WLI组,比较2组患者的活检率、活检阳性率和检出率等。结果 共纳入患者8 010例,其中M-NBI组7 161例,C-WLI组849例。与C-WLI组相比,M-NBI组具有更高的活检率(19.69%vs. 14.49%,P=0.000),对上消化道早期癌及癌前病变有更高的活检阳性率(12.34%vs. 5.69%,P=0.028)及检出率(2.43%vs. 0.82%,P=0.003)。结论 M-NBI在上消化道机会性筛查中具有较高的检出率及活检阳性率,表明其具有更好的筛查效率,适用于人群上消化道肿瘤的机会性筛查。

Objective To evaluate the diagnostic value of magnifying endoscopy with narrow-band imaging( M-NBI) for early carcinoma and precancerous lesions of upper gastrointestinal tract in population opportunistic screening. Methods Patients who underwent upper gastrointestinal endoscopy in the Digestive Endoscopy Center of our hospital from August to October 2018 were selected as the research objects. The patients examined by M-NBI were included in the M-NBI group,and the patients examined by conventional white-light imaging( C-WLI)were included in the C-WLI group. The biopsy rate,biopsy positive rate and detection rate of the two groups were compared. Results A total of 8 010 patients were included,including 7 161 cases in the M-NBI group and 849 cases in the C-WLI group. Compared with the C-WLI group,the M-NBI group had a higher biopsy rate( 19. 69% vs. 14. 49%,P = 0. 000),a higher biopsy positive rate( 12. 34% vs. 5. 69%,P = 0. 028) and detection rate( 2. 43% vs. 0. 82%,P = 0. 003) for early carcinoma and precancerous lesions in the upper gastrointestinal tract. Conclusion M-NBI has a higher detection rate and biopsy positive rate in the opportunistic screening of upper gastrointestinal tract,indicating that M-NBI has better screening efficiency and is suitable for opportunistic screening of upper digestive tract tumors in the population.