近焦联合窄带成像技术在胃黏膜病变靶向活检中的应用价值

Application value of Near-focus Narrow-band Imaging in Targeted Biopsy of Gastric Mucosal Lesions

目的:探讨近焦联合窄带成像技术(NF-NBI)在胃黏膜病变靶向活检中的应用价值。方法:选择2019年1月—2021年9月苏州大学附属第一医院消化科行内镜检查发现胃黏膜局灶性病变且行镜下活检的患者210例为研究对象,按照胃镜检查方法不同分为白光内镜+靶向活检组(n=98)、NBI内镜+靶向活检组(n=58)、NF-NBI内镜+靶向活检组(n=54)。比较三组患者内镜下活检早期胃癌阳性率及内镜图像清晰度。结果:NF-NBI内镜+靶向活检组胃早癌活检阳性率高于其他两组,NBI内镜+靶向活检组胃早癌检出率高于白光内镜+靶向活检组,差异有统计学意义(P=0.046);NF-NBI内镜+靶向活检组患者内镜图像病变形态、黏膜表面结构、微血管形态清晰度评分均高于白光内镜+靶向活检组和NBI内镜+靶向活检组,差异有统计学意义(P<0.001)。结论:NF-NBI内镜下活检早期胃癌阳性率更高,胃黏膜可疑病变的微血管、腺体结构成像更清晰、准确,在非病理活检情况下也能够对胃黏膜可疑病变进行较准确的判断。

Objective:To explore the therapeutic value of near-focus narrow-banding imaging(NF-NBI)in targeted biopsy of gas⁃tric mucosal lesions.Methods:210 patients with focal gastric mucosal lesions detected by endoscopy and underwent microscopic biopsy in the Department of Gastroenterology of the First Affiliated Hospital of Soochow University from January 2019 to Septem⁃ber 2021 were selected as the study subjects.According to different endoscopic methods they were divided into three groups:white light endoscopy+targeted biopsy group(n=98),NBI endoscopy+targeted biopsy group(n=58),and NF-NBI endoscopy+tar⁃geted biopsy group(n=54).The positive rate of endoscopic biopsy of early gastric cancer and the clarity of endoscopic images were compared among the three groups.Results:The positive rate of early gastric cancer biopsy in the NF-NBI endoscopy+targeted bi⁃opsy group was higher than that of the other two groups,and the detection rate of early gastric cancer in the NBI endoscopy+target⁃ed biopsy group was higher than that of the white light endoscopy+targeted biopsy group,with the difference statistically signifi⁃cant(P=0.046);the lesion morphology of the endoscopic images,the structure of mucous membrane surface,and the clarity scores of microvessels of the patients in the NF-NBI endoscopy+targeted biopsy group were higher than those of the white light endosco⁃py+targeted biopsy group and NBI endoscopy+targeted biopsy group,and the difference was statistically significant(P<0.001).Conclusion:NF-NBI endoscopic biopsy has a higher positive rate of early gastric cancer,and the imaging of microvessels and glandular structures of gastric mucosal suspicious lesions is clearer and more accurate;in the cases without pathological examina⁃tion NF-NBI endoscopic biopsy is able to a accurate diagnose to gastric mucosal lesions.