胃镜联合NBI技术在早期胃癌及癌前病变诊断中的应用观察

Observation on the Application of Gastroscopy Combined with NBI in the Diagnosis of Early Gastric Cancer and Precancerous Lesions

目的:观察胃镜联合窄带成像(NBI)技术应用于早期胃癌及癌前病变临床诊断的价值。方法:回顾性选取上饶卫生学校附属医院2020年1月—2022年3月收治的胃黏膜病变患者80例为研究对象,以病理检查为金标准,所有患者均行胃镜和NBI技术检查,比较胃镜、胃镜联合NBI技术的诊断价值。结果:胃镜联合NBI技术的微血管图像质量评分、腺管图像质量评分、病灶轮廓、胃黏膜表层形态评分均明显高于胃镜(P<0.05);经病理实验证实,早期胃癌及癌前病变为36例,非早期胃癌及癌前病变例数为44例。其中胃镜诊断早期胃癌及癌前病变30例,非早期胃癌及癌前病变50例;胃镜联合NBI技术诊断早期胃癌及癌前病变35例,非早期胃癌及癌前病变45例。胃镜联合NBI技术诊断的敏感度、特异度、准确率、阳性预测值、阴性预测值分别为80.56%、86.36%、83.75%、82.86%、84.44%,明显高于胃镜诊断的44.44%、68.18%、57.50%、53.33%、60.00%(P<0.05)。结论:两种检查方法对早期胃癌及癌前病变诊断均有重要诊断价值,但胃镜联合NBI技术对早期胃癌及癌前病变的诊断效能更高。

Objective:To observe the value of gastroscopy combined with narrow-band imaging(NBI)in clinical diagnosis of early gastric cancer and precancerous lesions.Method:A total of 80 patients with gastric mucosal lesions who were admitted to Shangrao Health School Affiliated Hospital from January 2020 to March 2022 were retrospectively selected as the research subjects.All patients underwent gastroscopy and NBI.Pathological examination was taken as the golden standard to compare the diagnostic value of the gastroscopy,gastroscopy combined with NBI.Result:The scores of gastroscopy combined with NBI were significantly higher than those of gastroscopy in terms of microvascular image quality,glandular duct image quality,focus contour and gastric mucosa surface morphology(P<0.05).Pathology confirmed 36 cases of early gastric cancer and precancerous lesions,and 44 cases of non-early gastric cancer or precancerous lesions.Gastroscopy confirmed 30 cases of early gastric cancer and precancerous lesions,and 50 cases of non-early gastric cancer or precancerous lesions.Gastroscopy combined with NBI confirmed 35 cases of early gastric cancer and precancerous lesions,and 45 cases of non-early gastric cancer or precancerous lesions.The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value of gastroscopy combined with NBI(80.56%,86.36%,83.75%,82.86%and 84.44%)were significantly higher than those of gastroscopy(44.44%,68.18%,57.50%,53.33%and 60.00%)(P<0.05).Conclusion:Both examination methods have important diagnostic value for early gastric cancer and precancerous lesions,but gastroscopy combined with NBI has higher diagnostic efficacy for early gastric cancer and precancerous lesions.