A Comprehensive Study on the digestive Endoscopic Technique and Narrow-Band Imaging for Early Gastric Cancer Screening

Objective:To explore the implementation of gastrointestinal endoscopy technology and endoscopic narrow-band imaging(NBI)in the early screening of gastric cancer and to observe and study their application effects.Methods:During the period from March 2023 to August 2023,312 patients who received gastroscopy in the Kunming Guandu District People’s Hospital were selected,and they underwent both conventional gastroscopy and endoscopic NBI,with clinicopathological tissue biopsy serving as the gold standard.The application value for early screening of gastric cancer was observed and analyzed.Results:The scoring data showed that the clarity of gastric mucosal glandular tube structure,microvascular structure clarity,and lesion contour scoring data of conventional gastroscopy were lower than those of the NBI technology(P<0.05).The screening rate of pathological biopsy in 312 patients was 18.59%(58 cases).Conventional gastroscopy showed a screening rate of 11.53%(36 cases),while NBI technology examined a screening rate of 17.63%(55 cases),and the two-by-two comparison of the screening rate data of the three groups was not statistically significant(P>0.05).The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of conventional gastroscopy appeared to be lower than those of NBI technology(P<0.05).Conclusion:In the early screening of gastric cancer,endoscopic NBI technology can be applied to patients.Compared with conventional gastroscopy,it provides a clearer visualization of the structure of the gastric mucosal glandular structure and microvascular structure,with a certain screening rate.Additionally,its sensitivity,specificity,accuracy,positive predictive value,and negative predictive value are higher,demonstrating outstanding effectiveness.

Could near focus endoscopy,narrow-band imaging,and acetic acid improve the visualization of microscopic features of stomach mucosa?

BACKGROUND Conventional magnifying endoscopy with narrow-band imaging(NBI)observation of the gastric body mucosa shows dominant patterns in relation to the regular arrangement of collecting venules,subepithelial capillary network,and gastric pits.AIM To evaluate the effectiveness of a new one-dual(near)focus,NBI mode in the assessment of the microscopic features of gastric body mucosa compared to conventional magnification.METHODS During 2021 and 2022,68 patients underwent proximal gastrointestinal endoscopy using magnification endoscopic modalities subsequently applying acetic acid(AA).The GIF-190HQ series NBI system with dual focus capability was used for the investigation of gastric mucosa.At the time of the endoscopy,the gastric body mucosa of all enrolled patients was photographed using the white light endoscopy(WLE),near focus(NF),NF-NBI,AA-NF,and AA-NF-NBI modes.RESULTS The WLE,NF and NF-NBI endoscopic modes for all patients(204 images)were classified in the same order into three groups.Two images from each patient for the AA-NF and AA-NF-NBI endoscopic modes were classified in the same order.According to all three observers who completed the work independently,NF magnification was significantly superior to WLE(P<0.01),and the NF-NBI mode was significantly superior to NF magnification(P<0.01).After applying AA,the three observers confirmed that AA-NF-NBI was significantly superior to AA-NF(P<0.01).Interobserver kappa values for WLE were 0.609,0.704,and 0.598,respectively and were 0.600,0.721,and 0.637,respectively,for NF magnification.For the NF-NBI mode,the values were 0.378,0.471,and 0.553,respectively.For AA-NF,they were 0.453,0.603,and 0.480,respectively,and for AA-NF-NBI,they were 0.643,0.506,and 0.354,respectively.CONCLUSION When investigating gastric mucosa in microscopic detail,NF-NBI was the most powerful endoscopic mode for assessing regular arrangement of collecting venules,subepithelial capillary network,and gastric pits among the five endoscopic modalities investigated in this study.AA-NF-NBI was the most powerful endoscopic mode for analyzing crypt opening and intervening part.

Diagnostic performance of narrow-band imaging international colorectal endoscopic and Japanese narrow-band imaging expert team classification systems for colorectal cancer and precancerous lesions

BACKGROUND In recent years,two new narrow-band imaging(NBI)classifications have been proposed:The NBI international colorectal endoscopic(NICE)classification and Japanese NBI expert team(JNET)classification.Most validation studies of the two new NBI classifications were conducted in classification setting units by experienced endoscopists,and the application of use in different centers among endoscopists with different endoscopy skills remains unknown.AIM To evaluate clinical application and possible problems of NICE and JNET classification for the differential diagnosis of colorectal cancer and precancerous lesions.METHODS Six endoscopists with varying levels of experience participated in this study.Eighty-seven consecutive patients with a total of 125 lesions were photographed during non-magnifying conventional white-light colonoscopy,non-magnifying NBI,and magnifying NBI.The three groups of endoscopic pictures of each lesion were evaluated by the six endoscopists in randomized order using the NICE and JENT classifications separately.Then we calculated the six endoscopists’sensitivity,specificity,accuracy,positive predictive value,and negative predictive value for each category of the two classifications.RESULTS The sensitivity,specificity,and accuracy of JNET classification type 1 and 3 were similar to NICE classification type 1 and 3 in both the highly experienced endoscopist(HEE)and less-experienced endoscopist(LEE)groups.The specificity of JNET classification type 1 and 3 and NICE classification type 3 in both the HEE and LEE groups was>95%,and the overall interobserver agreement was good in both groups.The sensitivity of NICE classification type 3 lesions for diagnosis of SM-d carcinoma in the HEE group was significantly superior to that in the LEE group(91.7%vs 83.3%;P=0.042).The sensitivity of JNET classification type 2B lesions for the diagnosis of high-grade dysplasia or superficial submucosal invasive carcinoma in the HEE and LEE groups was 53.8%and 51.3%,respectively.Compared with other types of JNET classification,the diagnostic ability of type 2B was the weakest.CONCLUSION The treatment strategy of the two classification type 1 and 3 lesions can be based on the results of endoscopic examination.JNET type 2B lesions need further examination.

Endoscopic diagnosis of cervical esophageal heterotopic gastric mucosa with conventional and narrow-band images

AIM: To compare the diagnostic yield of heterotopic gastric mucosa (HGM) in the cervical esophagus with conventional imaging (CI) and narrow-band imaging (NBI).

Diagnostic utility of narrow-band imaging endoscopy for pharyngeal superfi cial carcinoma

AIM: To investigate the endoscopic features of pharyngeal superfi cial carcinoma and evaluate the utility of narrow-band imaging (NBI) for this disease. METHODS: In the present prospective study, 335 patients underwent conventional white light (CWL) en-doscopy and non-magnifi ed/magnifi ed NBI endoscopy, followed by an endoscopic biopsy, for 445 superfi cial lesions in the oropharynx and hypopharynx. The macroscopic appearance of superfi cial lesions was categorized as either elevated (< 5 mm in height), flat, or depressed (not ulcerous). Superficial carcinoma (SC) was defi ned as a superfi cial lesion showing high-grade dysplasia or squamous cell carcinoma on histology. The color, delineation, and macroscopic appearances of the lesions were evaluated by CWL endoscopy. The ratio of the brownish area/intervascular brownish epithelium (IBE), as well as microvascular proliferation, dilation, and irregularities, was determined by non-magnifi ed/ magnifi ed NBI endoscopy. An experienced pathologist who was unaware of the endoscopic fi ndings made the histological diagnoses. By comparing endoscopic fi ndings with histology, we determined the endoscopic features of SC and evaluated the diagnostic utility of NBI. RESULTS: The 445 lesions were divided histologically into two groups: a non-SC group, including non-neoplasia and low-grade dysplasia cases, and an SC group. Of the 445 lesions examined, 333 were classified as non-SC and 112 were classif ied as SC. There were no significant differences in age, gender, or the location of the lesions between the patients in the two groups. The mean diameter of the SC lesions was signif icantly greater than that of non-SC lesions (11.0 ± 7.6 mm vs 4.6 ± 3.6 mm, respectively, P < 0.001). Comparisons of CWL endoscopy fi ndings for SC and non-SC lesions by univariate analysis revealed that the incidence of redness (72% vs 41%, respectively, P < 0.001) and a flat or depressed type of lesion (58% vs 44%, respectively, P = 0.013) was significantly higher in the SC group. Using non-magnifi ed NBI endoscopy, the incidence of a brownish area was signifi cantly higher for SC lesions (79% vs 57%, respectively, P < 0.001). On magnifi ed NBI endoscopy, the incidence of IBE (68% vs 33%, P < 0.001) and microvascular proliferation (82% vs 51%, P < 0.001), dilation (90% vs 76%, P =0.002), and irregularity (82% vs 31%, P < 0.001) was also signifi cantly higher for the SC compared with the non-SC lesions. Multivariate analysis revealed that the incidence of redness (P = 0.022) on CWL endoscopy and IBE (P < 0.001) and microvascular irregularities (P < 0.001) on magnif ied NBI endoscopy was signif icantly higher in SC than non-SC lesions. Redness alone exhibited signifi cantly higher sensitivity and signifi cantly lower specifi city for the diagnosis of SC compared with redness plus IBE and microvascular irregularities (72% vs 52%, P = 0.002; and 59% vs 92%, P < 0.001, respectively). The accuracy of redness plus IBE and irregularities for the diagnosis of SC was signifi cantly greater than using redness alone (82% vs 62%, respectively, P < 0.001). CONCLUSION: Redness, IBE, and microvascular irregularities appear to be closely related to SC lesions. Magnifi ed NBI endoscopy may increase the diagnostic accuracy of CWL endoscopy for SC.

Quest for the best endoscopic imaging modality for computer-assisted colonic polyp staging

BACKGROUND It was shown in previous studies that high definition endoscopy, high magnification endoscopy and image enhancement technologies, such as chromoendoscopy and digital chromoendoscopy [narrow-band imaging(NBI), iScan] facilitate the detection and classification of colonic polyps during endoscopic sessions. However, there are no comprehensive studies so far that analyze which endoscopic imaging modalities facilitate the automated classification of colonic polyps. In this work, we investigate the impact of endoscopic imaging modalities on the results of computer-assisted diagnosis systems for colonic polyp staging.AIM To assess which endoscopic imaging modalities are best suited for the computerassisted staging of colonic polyps.METHODS In our experiments, we apply twelve state-of-the-art feature extraction methods for the classification of colonic polyps to five endoscopic image databases of colonic lesions. For this purpose, we employ a specifically designed experimental setup to avoid biases in the outcomes caused by differing numbers of images per image database. The image databases were obtained using different imaging modalities. Two databases were obtained by high-definition endoscopy in combination with i-Scan technology(one with chromoendoscopy and one without chromoendoscopy). Three databases were obtained by highmagnification endoscopy(two databases using narrow band imaging and one using chromoendoscopy). The lesions are categorized into non-neoplastic and neoplastic according to the histological diagnosis.RESULTS Generally, it is feature-dependent which imaging modalities achieve high results and which do not. For the high-definition image databases, we achieved overall classification rates of up to 79.2% with chromoendoscopy and 88.9% without chromoendoscopy. In the case of the database obtained by high-magnification chromoendoscopy, the classification rates were up to 81.4%. For the combination of high-magnification endoscopy with NBI, results of up to 97.4% for one database and up to 84% for the other were achieved. Non-neoplastic lesions were classified more accurately in general than non-neoplastic lesions. It was shown that the image recording conditions highly affect the performance of automated diagnosis systems and partly contribute to a stronger effect on the staging results than the used imaging modality.CONCLUSION Chromoendoscopy has a negative impact on the results of the methods. NBI is better suited than chromoendoscopy. High-definition and high-magnification endoscopy are equally suited.

Endoscopic advances in the management of gastric cancer and premalignant gastric conditions

Gastric cancer is the fifth most common cancer and in 2018,it was the third most common cause of cancer-related deaths worldwide.Endoscopic advances continue to be made for the diagnosis and management of both early gastric cancer and premalignant gastric conditions.In this review,we discuss the epidemiology and risk factors of gastric cancer and emphasize the differences in early vs latestage gastric cancer outcomes.We then discuss endoscopic advances in the diagnosis of early gastric cancer and premalignant gastric lesions.This includes the implementation of different imaging modalities such as narrow-band imaging,chromoendoscopy,confocal laser endomicroscopy,and other experimental techniques.We also discuss the use of endoscopic ultrasound in the diagnosis and staging of early gastric cancer.We then discuss the endoscopic advances made in the treatment of these conditions,including endoscopic mucosal resection,endoscopic submucosal dissection,and hybrid techniques such as laparoscopic endoscopic cooperative surgery.Finally,we comment on the current suggested recommendations for surveillance of both gastric cancer and its premalignant conditions.

Narrow-band imaging observation of colorectal lesions using NICE classification to avoid discarding significant lesions

AIM: To assess the risk of failing to detect diminutive and small colorectal cancers with the "resect and discard" policy.METHODS: Patients who received colonoscopy and polypectomy were recruited in the retrospective study. Probable histology of the polyps was predicted by six colonoscopists by the use of NICE classification. The incidence of diminutive and small colorectal cancersand their endoscopic features were assessed. RESULTS: In total, we found 681 cases of diminutive(1-5 mm) lesions in 402 patients and 197 cases of small(6-9 mm) lesions in 151 patients. Based on pathology of the diminutive and small polyps, 105 and 18 were non-neoplastic polyps, 557 and 154 were low-grade adenomas, 18 and 24 were high-grade adenomas or intramucosal/submucosal(SM) scanty invasive carcinomas, 1 and 1 were SM deeply invasive carcinoma, respectively. The endoscopic features of invasive cancer were classified as NICE type 3 endoscopically.CONCLUSION: The risk of failing to detect diminutive and small colorectal invasive cancer with the "resect and discard" strategy might be avoided through the use of narrow-band imaging observation with the NICE classification scheme and magnifying endoscopy.

Gastric adenocarcinoma of fundic gland type: Five cases treated with endoscopic resection

Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was proposed.We treated five cases of GA-FG with endoscopic submucosal dissection.All tumors were small and located in the upper third of the stomach.Four tumors were macroscopically identified as 0-IIa and one was identified as 0-Ⅱb.Narrow-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the remainder.All tumors arose from the deep layer of the lamina propria mucosae and showed submucosal invasion.Lymphatic invasion was seen only in one case,while no venous invasion was recognized.All tumors were positive for pepsinogen-Ⅰ and MUC6 by immunohistochemistry.None showed p53 overexpression,and the labeling index of Ki-67 was low in all cases.All cases have been free from recurrence or metastasis.Herein,we discussed the clinicopathological features of GA-FG in comparison with past reports.

超声内镜结合LCI/BLI-ME判断根除幽门螺杆菌后早期胃癌浸润深度的研究

目的 探讨超声内镜结合联动成像技术/蓝激光成像技术-放大内镜(LCI/BLI-ME)对根除幽门螺杆菌后早期胃癌浸润深度的判断及其准确性的影响因素,评价其临床应用价值。方法 收集2017年10月至2023年6月武汉市第一医院收治的91例根除幽门螺杆菌后早期胃癌患者的临床资料,以病理学检查结果作为判断标准,总结根除幽门螺杆菌后胃黏膜及早期胃癌在内镜下的特征表现,分析超声内镜结合LCI/BLI-ME对根除幽门螺杆菌后早期胃癌浸润深度的判断准确性及影响其判断准确性的相关因素。诊断效能的统计学描述采用灵敏度、特异度、准确度表示;采用χ^(2)检验和多因素Logistic回归分析对超声内镜的诊断结果与术后病理学检查结果进行比较。结果 超声内镜结合LCI/BLI-ME对根除幽门螺杆菌后早期胃癌浸润深度判断的总体准确率77.08%,对uT1a期及uT1b期的判断准确率分别为82.86%和61.53%。分期不足12例,占17.14%;分期过度10例,占38.46%。对黏膜层病变判断的诊断敏感度85.29%,诊断特异度57.14%,阳性预测值82.86%,阴性预测值61.5%。单因素和多因素Logistic回归分析结果表明,病变最大径、组织分化类型是影响判断准确性的因素,而病变部位、病灶形态与判断准确性无相关性。病灶越大,对浸润深度判断的准确性越低;组织分化程度越低,对浸润深度判断的准确性越低。结论 超声内镜结合LCI/BLI-ME对根除幽门螺杆菌后早期胃癌uT1a期的浸润深度判断具有较好的临床应用价值,病灶大小及组织分化程度对判断的准确性有影响。

三维立体成像联合仿真内镜技术在支气管扩张合并感染患者支气管镜下肺泡灌洗术前检查的应用价值

目的探讨三维立体成像联合仿真内镜技术在支气管扩张合并感染患者行支气管肺泡灌洗术(BAL)术前检查的临床应用效果。方法选取2023年1—6月于医院拟行BAL治疗的100例支气管扩张合并感染患者,按随机数字表法分为对照组和试验组,每组50例。BAL术前,对照组采取常规CT检查,试验组采取三维立体成像联合仿真内镜技术检查。比较两组气道情况、气管镜检查的定位准确率及术后并发症发生情况。结果试验组气道与周围结构关系清晰图像占比高于对照组,差异有统计学意义(P<0.05);试验组定位准确率高于对照组,术后并发症发生率低于对照组,差异有统计学意义(P<0.05);两组气道位置扭曲、管腔扩张、管壁增厚图像占比比较,差异无统计学意义(P>0.05)。结论BAL术前,支气管扩张合并感染患者采用三维立体成像联合仿真内镜技术检查,能更清晰地展示气道情况、提高肺泡灌洗的定位准确率,降低并发症发生风险。

Histopathological validation of magnifying endoscopy for diagnosis of mixed-histological-type early gastric cancer

BACKGROUND The undifferentiated-type(UDT)component profoundly affects the clinical course of early gastric cancers(EGCs).However,an accurate preoperative diagnosis of the histological types is unsatisfactory.To date,few studies have investigated whether the UDT component within mixed-histological-type(MT)EGCs can be recognized preoperatively.AIM To clarify the histopathological characteristics of the endoscopically-resected MT EGCs for investigating whether the UDT component could be recognized preoperatively.METHODS This was a single-center retrospective study.First,we attempted to clarify the histopathological characteristics of the endoscopically-resected MT EGCs with emphasis on the UDT component.Histopathological examination investigated each lesion’s UDT component:(1)Whole mucosal layer occupation of the UDT component;(2)UDT component exposure to the surface of the mucosa;and(3)existence of a clear border between the differentiated-type and UDT components.Then,preoperative endoscopic images with magnifying endoscopy with narrowband imaging(ME-NBI)were examined to identify whether the endoscopic UDT component finding was recognizable within the area where it was present in the histopathological examination.The preoperative biopsy results and comparative relationships between endoscopic and histopathological findings were also examined.RESULTS In the histopathological examination,the whole mucosal layer occupation of the UDT component and exposure of the UDT component to the mucosal surface were observed in 67.3%(33/49)and 79.6%(39/49)of samples,respectively.A clear distinction of the border between the differentiated-type and UDT components could not be drawn in 65.3%(32/49)of MT lesions.In the endoscopic examination,the preoperative endoscopic images showed that only 24.5%(12/49)of MT EGCs revealed the UDT component within the area where it was present histopathologically.Histopathological UDT predominance was the single significant factor associated with the presence of the endoscopic UDT component finding(61.5%vs 11.1%,P=0.0009).Only 26.5%(13/49)of the lesions were diagnosed from the pretreatment biopsy as having a UDT component.Combined results of the pretreatment biopsy and ME-NBI showed the preoperative presence of the UDT component in 40.8%(20/49)of MT EGCs.CONCLUSION Recognition of a UDT component within MT EGCs is difficult even when pretreatment biopsy and ME-NBI are combined.Endoscopic resection plays a significant role in both treatment and diagnosis.

喷水推进泵内窥式非定常流场测量技术

为了突破壳体引起的视场粒子图像局部畸变限制,实现泵内多关键流场信息精细化测量,将内窥镜技术与粒子图像测速(PIV)技术相结合,提出了适用于喷水推进泵的内窥式PIV非定常流场测量方法。以前置导叶喷水推进泵为研究对象,采用该方法测量了导叶前、叶轮后及静动间轴截面非定常、周期性流场速度分布,分析了不同工况下泵内多关键流域的流动规律与特性。试验结果验证了该方法的可行性。

白光内镜、放大内镜及放大内镜联合窄带成像技术对早期胃癌的诊疗价值

目的探讨早期胃癌诊疗中白光内镜、放大内镜及放大内镜联合窄带成像技术的应用价值。方法回顾性选取2019年3月至2022年3月三二〇一医院疑似早期胃癌患者320例,统计3种检查方法的检测结果,分析320例早期胃癌患者的临床与病理特征,并分析早期胃癌患者微血管分型、微腺管分型与临床病理特征的相关性。结果放大内镜联合窄带成像技术诊断早期胃癌的灵敏性(80.00%)明显高于白光内镜(65.00%)和放大内镜(75.00%),差异有统计学意义(P<0.05),放大内镜检查的灵敏性明显高于白光内镜,差异有统计学意义(P<0.05),但三者的特异性、准确性、阳性预测值、阴性预测值之间的差异均无统计学意义(P>0.05)。分化程度为分化型患者的微血管分型FNP、ILL-1比率均明显高于未分化型患者,ILL-2、CSP比率均明显低于未分化型患者,差异均有统计学意义(P<0.05);镜下分型隆起型患者的微血管分型FNP、ILL-1比率均明显高于凹陷型或平坦型患者,ILL-2、CSP比率均明显低于凹陷型或平坦型患者,差异均有统计学意义(P<0.05)。未分化型患者的微腺管分型Ⅳ型、Ⅴ型比率均明显高于未分化型,Ⅵ型比率明显低于未分化型,差异均有统计学意义(P<0.05)。结论放大内镜联合窄带成像技术在早期胃癌诊疗中的应用价值明显高于白光内镜和放大内镜。

近红外自体荧光显像技术辅助腔镜甲状腺手术对甲状腺良性肿瘤的治疗效果

目的 探讨近红外自体荧光显像技术辅助腔镜甲状腺手术对甲状腺良性肿瘤的治疗效果。方法 回顾性选取2017年1月至2019年12月佳木斯市中心医院收治的90例甲状腺良性肿瘤患者作为研究对象,依照患者应用的手术方式进行分组,将采用传统开放手术的45例患者设为对照组,将45例采用近红外自体荧光显像技术辅助的腔镜甲状腺手术患者设为观察组。比较两组患者相关围手术期指标,手术前后C反应蛋白(CRP)、白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)表达水平,术后疼痛程度、美观度与满意度,术后短期并发症发生率,并对所有患者进行3年随访,比较术后甲状腺肿瘤复发情况。结果 观察组患者手术时间、术中出血量、切口大小以及住院时间分别为(72.27±12.82) min、(15.31±3.27) mL、(16.01±2.51) cm、(8.46±1.37) d,均低于对照组[(87.25±13.12) min、(23.27±5.18) mL、(77.31±12.51) cm、(9.36±2.68) d],差异均有统计学意义(P<0.05),两组患者术后引流量比较,差异无统计学意义(P>0.05)。手术后,两组患者CRP、TNF-α水平均较手术前升高,IL-2水平均较手术前降低,观察组CRP、TNF-α水平分别为(161.12±16.12)μg/mL、(13.63±2.52) mg/L,均低于对照组[(196.21±13.93)μg/mL、(15.68±3.12) mg/L],IL-2水平为(3.02±1.25)μg/L,高于对照组[(2.32±0.32)μg/L],差异均有统计学意义(P<0.05)。观察组PSAS、VAS评分分别为(12.53±3.15)、(3.27±0.77)分,均低于对照组[(19.58±3.84)、(4.17±1.31)分],满意度评分为(7.68±1.63)分,高于对照组[(5.58±1.26)分],差异均有统计学意义(P<0.05)。观察组患者术后并发症发生率为6.67%,低于对照组(22.22%),差异有统计学意义(P<0.05)。观察组患者术后1、2、3年总复发率为13.33%,低于对照组(35.55%),差异有统计学意义(P<0.05)。结论 对甲状腺良性肿瘤患者采取近红外自体荧光显像技术辅助腔镜甲状腺手术能够缩短患者手术时间、减少术中出血量,促进患者早日康复,同时能够降低患者术后机体炎症反应,降低术后短期并发症发生率,减轻术后疼痛程度,提升术后美观度与满意度,且患者远期复发率较低。

Update on diagnosis and treatment of early signet-ring cell gastric carcinoma: A literature review

Gastric signet-ring cell gastric carcinoma(GSRC)is an unfavorable subtype of gastric cancer(GC)that presents with greater invasiveness and poorer prognosis in advanced stage than other types of GC.However,GSRC in early stage is often considered an indicator of less lymph node metastasis and more satisfying clinical outcome compared to poorly differentiated GC.Therefore,the detection and diagnosis of GSRC at early stage undoubtedly play a crucial role in the management of GSRC patients.In recent years,technological advancement in endoscopy including narrow-band imaging and magnifying endoscopy has significantly improved the accuracy and sensitivity of the diagnosis under endoscopy for GSRC patients.Researches have confirmed that early stage GSRC that meets the expanded criteria of endoscopic resection showed comparable outcomes to surgery after receiving endoscopic submucosal dissection(ESD),indicating that ESD could be considered standard treatment for GSRC after thorough selection and evaluation.This article summarizes the current knowledge and updates pertaining to the endoscopic diagnosis and treatment of early stage signet-ring cell gastric carcinoma.

内镜窄带成像技术用于消化道早癌及癌前病变的筛查及临床评价

目的分析内镜窄带成像技术用于消化道早癌及癌前病变的筛查效果。方法回顾性分析2022年9—12月消化道早癌及癌前病变患者的数据资料,共计112例,其中14例患者经常规消化道内镜检查(对照组)、另98例患者经内镜窄带成像技术检查(实验组),对比两组检查结果。结果(1)对照组和实验组之间的消化道早癌及癌前病变检出率、误诊率、漏诊率有明显差异(P<0.05)。(2)对照组和实验组之间的病变轮廓、病变微形态、微血管形态评分有明显差异(P<0.05)。结论内镜窄带成像技术是内镜下成像诊断新手段,在消化道疾病诊断中有着极大的应用价值,不仅弥补了常规内镜不足,也有着操作简单等优势,极大地提高了消化道早癌及癌前病变的检出率,对疾病早发现、早治疗有着很大意义。

医用超细内窥镜系统研究

设计了一种医用超细内窥镜系统。采用微型、高分辨率的CMOS图像传感器配合低压差分信号(LVDS)传输技术进行前端摄像探头的设计,使摄像探头直径缩减至5.0 mm,并实现了图像数据的长距离高保真传输;采用基于S3C2440微处理器的ARM开发平台对图像数据进行处理,实现了内窥镜图像的清晰显示。以口腔为模拟测试对象对系统摄像功能进行了测试,并与传统内镜进行了对比,证明该系统能够完成内窥镜摄像,且所成图像分辨率高。以口腔溃疡模拟粘膜病变对系统进行测试,证明该系统能有效发现粘膜病变,病变检出率高达90.0%。本系统成像清晰,且镜体直径小,能大大提高病人内镜检查的舒适性,为消化道疾病普查初筛提供了一种理想的解决方案。

高压电力设备放电在线监测系统

针对高压电力设备局部放电对电力系统安全运行造成重大影响的现状,研究了一套基于嵌入式系统的电力设备紫外内窥系统。该系统主要由紫外内窥探头、嵌入式计算机系统和GPRS模块构成。在嵌入式计算机系统部分介绍了该系统的硬件、软件组成框架和USB摄像头的视频图像采集过程,并在此基础上实现了基于Qtopia的紫外内窥软件程序的编写。利用日盲型的紫外传感器,可以通过检测特定波长的紫外线来正确检测电力设备的放电。通过对电力设备内部特殊环境的研究,将紫外放电检测和视频内窥技术相结合,实现了基于无线GPRS的电力设备紫外放电的远程实时在线监测。实验证明了该系统能够可靠地运行,有效地防止由放电引起的电力事故的发生。

基于MEMS技术的胃肠道无线内窥镜的研究

胃肠道无线内窥镜主要用于胃肠道疾病的诊断。其核心部分为一可吞服的胃肠道摄像无线发射的药丸,可将摄取到的胃肠道图像通过调制以无线方式发送出体外,然后经过信号解调,还原出视频信号,由计算机进行图像采集和处理。研究的关键在于摄像药丸的微型化和无线传输图像的稳定性。利用MEMS技术可以大大缩小摄像电路和发射电路的尺寸,从而大大缩小摄像药丸的体积。