消化道早癌诊断中胃肠镜检查的作用

Effect of Gastroscopy in Diagnosis of Early Gastrointestinal Cancer

目的 本文探究消化道早癌诊断中胃肠镜检查的应用价值。方法 选取2021年10月—2023年5月本院消化内科收治的128例疑似消化道早癌患者为研究对象,对所有患者均实行胃肠镜检查,其中实施常规胃肠镜检查诊断的64例患者组别命名常规组,以胃肠镜双重染色法检查诊断的64例患者组别命名为染色组;以病理学检查结果作为诊断标准,判断128例患者消化道早癌确诊情况、患病类型,并比较两种胃肠镜诊断方式临床诊断效果,分析胃肠镜检查对于消化道早癌诊断实际意义。结果 以病理学诊断结果为金标准,常规组确诊消化道早癌56例,其中食管早癌、胃早癌、结直肠早癌分别26例、17例、13例,常规胃肠镜检出49例,对应食管早癌、胃早癌、结直肠早癌分别检出25例、12例、8例,误诊4例、漏诊11例;染色组消化道早癌确诊57例,其中食管早癌、胃早癌、结直肠早癌分别24例、18例、15例,双重染色法胃肠镜检出55例,对应食管早癌、胃早癌、结直肠早癌分别检出23例、17例、14例,误诊1例、漏诊3例;对比两组诊断效能,阳性检出率、灵敏度、阳性预测值、诊断符合率均较高,染色法灵敏度、诊断符合率更高(P<0.05),且双重染色法各类型消化道早癌诊断准确性明显高于常规胃肠镜检查法,差异有统计学意义(P<0.05)。结论 对疑似消化道早癌患者实行双重染色法胃肠镜检查,诊断效能较高,能有效检出并鉴别各类型消化道早癌情况,便于临床确诊相关疾病并进行早一步治疗,值得推广。

Objective To explore application value of gastroscopy in diagnosis of early gastrointestinal cancer.Methods The paper chose 128 suspected patients with early gastrointestinal cancer admitted to Department of Gastroenterology of our hospital from October 2021 to May 2023.All patients were treated with gastroscopy examination.64 cases in routine group were diagnosed by routine gastroscopy,and 64 cases in staining group by double staining of gastroscopy.Diagnosis and types of early gastrointestinal cancer of 128 patients were determined with diagnostic criteria of pathological examination results,clinical diagnostic effect between two gastrointestinal endoscopy diagnostic methods was compared.Practical significance of gastrointestinal endoscopy in diagnosis of early gastrointestinal cancer was analyzed.Results Based on gold standard of pathological diagnosis,56 cases of early gastrointestinal cancer were diagnosed in routine group,including 26 cases of early esophageal cancer,17 cases of early gastric cancer,and 13 cases of early colorectal cancer respectively.49 cases were detected by routine gastroscopy,including 25 cases of early esophageal cancer,12 cases of early gastric cancer,and 8 cases of early colorectal cancer respectively.There were 4 cases of misdiagnosis and 11 cases of missed diagnosis,57 cases of early gastrointestinal cancer were diagnosed in staining group,including 24 cases of early esophageal cancer,18 cases of early gastric cancer,and 15 cases of early colorectal cancer respectively.55 cases were detected by double staining gastroscopy,including 23 cases of early esophageal cancer,17 cases of early gastric cancer,and 14 cases of early colorectal cancer,with 1 case misdiagnosed and 3 cases missed.Comparison of diagnostic effect between two groups showed,positive detection rate,sensitivity,positive predictive value,and diagnostic accuracy were higher.Double staining method had higher sensitivity and diagnostic accuracy,diagnostic accuracy for various types of early gastrointestinal cancer than routine gastrointestinal endoscopy method(P<0.05),with statistical significance.Conclusion Double staining gastroscopy is highly effective in detecting and distinguishing various types of early gastrointestinal cancer of suspected patients,can detect and distinguish various types of early gastrointestinal cancer effectively,facilitate clinical diagnosis of related diseases and early treatment,which is worth promoting.