NBI-ME联合靛胭脂在消化道早期癌和癌前病变诊断中的应用

Application of NBI-ME combined with indigo carmine in the diagnosis of early gastrointestinal cancer and precancerous lesions

目的研究窄带成像放大内镜(NBI-ME)联合靛胭脂在消化道早期癌和癌前病变诊断中的应用价值。方法选择2020年1月至2021年12月咸阳市中心医院诊治的82例疑似消化道早期癌和癌前病变患者为研究对象,所有患者均接受NBI-ME、NBI-ME联合靛胭脂、组织病理学检查。以组织病理学结果作为金标准,比较NBI-ME、NBI-ME联合靛胭脂与金标准对消化道早期癌和癌前病变诊断的一致性,及NBI-ME、NBI-ME联合靛胭脂诊断消化道早期癌和癌前病变的灵敏度、特异度、阳性预测值、阴性预测值与病变轮廓清晰度。结果组织病理学结果显示,82例疑似消化道早期癌和癌前病变患者中早期癌和癌前病变47例,占比57.32%,非早期癌和癌前病变35例,占比42.68%;NBI-ME诊断消化道早期癌和癌前病变的准确率为86.59%(71/82);NBI-ME与组织病理学的一致性比较理想(Kappa=0.457;P<0.001);NBI-ME联合靛胭脂诊断消化道早期癌和癌前病变的准确率为96.34%(79/82);NBI-ME联合靛胭脂诊断与组织病理学的一致性极好(Kappa=0.598;P<0.001);NBI-ME联合靛胭脂检查的总清晰率为97.67%,明显高于NBI-ME的86.59%,差异有统计学意义(P<0.05);NBI-ME联合靛胭脂诊断消化道早期癌和癌前病变的特异性、阳性预测值分别为97.14%、97.83%,均高于NBI-ME单独诊断的82.86%、87.50%,差异均有统计学意义(P<0.05)。结论NBI-ME联合靛胭脂应用于消化道早期癌和癌前病变诊断有较高的应用价值,且能够清晰显示病变轮廓。

Objective To study the application value of narrow-band imaging magnifying endoscopy(NBI-ME)combined with indigo carmine in the diagnosis of early gastrointestinal cancer and precancerous lesions.Methods Eighty-two patients with suspected early gastrointestinal cancer and precancerous lesions diagnosed and treated in Xianyang Central Hospital from January 2020 to December 2021 were selected as subjects.All patients received NBI-ME,NBI-ME combined with indigo carmine,and histopathological examinations.Using histopathological results as the gold standard,the consistency of NBI-ME,NBI-ME combined with indigo carmine,and gold standard in the diagnosis of early gastrointestinal cancer and precancerous lesions were compared,as well as the sensitivity,specificity,positive predictive value,negative predictive value,and lesion outline clarity of NBI-ME,NBI-ME combined with indigo carmine in the diagnosis of early gastrointestinal cancer and precancerous lesions.Results Histopathological results showed that 47 of the 82 patients had early gastrointestinal cancer and precancerous lesions(with the accuracy of 57.32%)and 35 had no early cancer and precancerous lesions(accounting for 42.68%).The accuracy of NBI-ME in diagnosing early gastrointestinal cancer and precancerous lesions was 86.59%(71/82).The consistency between NBI-ME and histopathology was ideal(Kappa=0.457;P<0.001).NBI-ME combined with indigo carmine showed a accuracy of 96.34%(79/82)in the diagnosis of early gastrointestinal cancer and precancerous lesions,which showed excellent agreement with histopathology(Kappa=0.598;P<0.001).The total clear rate of NBI-ME combined with indigo carmine examination was 97.67%,which was significantly higher than 86.59%of NBI-ME(P<0.05).The specificity and positive predictive values of NBI-ME combined with indigo carmine in the diagnosis of early gastrointestinal cancer and precancerous lesions were 97.14%and 97.83%,which were significantly higher than 82.86%and 87.50%of NBI-ME alone(P<0.05).Conclusion NBI-ME combined with indigo carmine has high diagnostic value in the diagnosis of early gastrointestinal cancer and precancerous lesions,which can clearly display the contour of the lesions.