EUS、白光内镜、ME-NBI在早期胃癌浸润深度诊断中的效果

Effects of EUS,white light endoscopy and ME-NBI in the diagnosis of depth of invasion of early gastric cancer

目的探讨超声内镜(endoscopic ultrasound,EUS)、白光内镜(white light endoscopy,WLI)、放大内镜结合窄带显像(enlarged endoscopy combined with narrowband imaging,ME-NBI)在早期胃癌浸润深度诊断中的效果。方法选取河北中石油中心医院治疗的早期胃癌患者78例。同时选取正常体检者60例为对照组,比较EUS、WLI、ME-NBI及三者联合诊断浸润深度的准确率差异。采用多因素Logistic回归模型分析建立数据模型分析影响EUS、WLI和ME-NBI三者联合诊断早期胃癌浸润深度准确率的相关因素。结果病理结果显示:T1a期患者50例,T1b期患者28例。在T1a病变中,EUS、WLI和ME-NBI三者联合诊断准确率为92.00%,明显高于EUS、WLI单独诊断(P<0.05)。在T1b病变中,EUS、WLI和ME-NBI三者联合诊断准确率为92.86%,明显高于WIL单独诊断(P<0.05)。病变大小≥2 cm患者EUS、WLI和ME-NBI三者联合诊断浸润深度准确率为77.29%,明显低于病变大小<2 cm患者(P<0.05)。凹陷型形态患者EUS、WLI和ME-NBI三者联合诊断浸润深度准确率为66.67%,明显低于隆起型、平坦型形态患者(P<0.05)。贲门胃底区病变EUS、WLI和ME-NBI三者联合诊断浸润深度准确率76.92%明显低于胃体区病变、胃窦幽门区病变(P<0.05)。多因素Logistic回归分析显示:病变大小、病变形态、病变部位是EUS、WLI和ME-NBI三者联合诊断浸润深度准确率的影响因素(P<0.05)。结论EUS、WLI和ME-NBI三者联合诊断早期胃癌浸润深度有较高的价值,三者联合诊断准确率受病变大小、病变形态、病变部位的影响。

Objective To explore the effect of endoscopic ultrasonography(EUS),white light endoscopy(WLE),magnifying endoscopy combined with narrowb and imaging(ME-NBI)in the diagnosis of depth of invasion of early gastric cancer.Methods A total of 78 patients with early gastric cancer treated in Hebei Petro China Central Hospital were selected,60 normal examiners were selected as controls,and the accuracy of EUS,WLI,ME-NBI alone and in combination in diagnosing the depth of invasion was compared.Logistic regression analysis was used to analyze the factors affecting the accuracy of EUS,WLI and ME-NBI in combination in the diagnosis of infiltration depth.Results Pathological results showed that there were 50 patients with T1a and 28 patients with T1b.In patients with T1a lesions,the combined diagnostic accuracy of EUS,WLI and ME-NBI was 92.00%,which was significantly higher than that of EUS and WLI alone(P<0.05).In patients with T1b lesions,the combined diagnostic accuracy of EUS,WLI and ME-NBI was 92.86%,which was significantly higher than that of WIL alone(P<0.05).The accuracy rate of EUS,WLI and ME-NBI in combination in diagnosing the depth of invasion in patients with lesion size≥2 cm was 77.29%,which was significantly lower than that in patients with lesion size<2 cm(P<0.05).The accuracy rate of EUS,WLI and ME-NBI in combination in the diagnosis of the depth of infiltration in patients with depressed form was 66.67%,which was significantly lower than that in patients with raised and flat form(P<0.05).The accuracy rate of EUS,WLI and ME-NBI incombination in the diagnosis of the depth of invasion in the lesions of the cardia and fundus of the stomach was 76.92%,which was significantly lower than that in the lesions of the gastric body and the gastric antrum and pylorus(P<0.05).Multivariate logistic regression analysis showed that the size,shape and location of the lesion were the influencing factors of the accuracy of EUS,WLI and ME-NBI in combination in the diagnosis of the depth of invasion(P>0.05).Conclusion The combined detection of EUS,WLI and ME-NBI has high value in the diagnosis of the depth of invasion of early gastric cancer,and the accuracy of the combined diagnosis of EUS,WLI and ME-NBI is affected by the size and shape of the lesion.