放大NBI内镜在早期胃癌诊断中的应用体会.docVIP

放大NBI内镜在早期胃癌诊断中的应用 体会 叶春荣付肖岩黄恒青 福建中医药大学附属第二人民医院脾胃科 目的通过对比分析放大NBI内镜(ME-NBI)与普通口光内镜(WLE)诊断早期 胃癌的准确性，评价其鉴别可疑病变的价值。方法回顾性分析行WLE或ME-NBI 内镜检查发现胃部界常病灶患者218例，根据内镜类型不同将患者分为观察组 110例和对照组108例。观察组行ME-NBI检查，对照组行WLE检查，2组病变均 进行组织活检或内镜下切除标本病理学检查。对比2组内镜下诊断与病理诊断的 情况，计算内镜诊断的敏感性、特异性、阳性预测值、阴性预测值和准确性。结 果 对照组患者WLE内镜下诊断癌性病变80例，经最终“金标准”病理诊断证实 其中癌变10例，非癌变70例;WLE内镜下诊断菲癌性病变28例，经最终“金标 准”病理诊断证实均为非癌变。观察组患者ME-NBI内镜下诊断癌性病变14例， 经最终“金标准”病理诊断证实其中癌变13例，非癌变1例;ME-NBT内镜下诊 断非癌性病变96例，经最终“金标准”病理诊断证实其屮非癌变94例，癌变2 例。对照组108例患者中，病理诊断证实非癌性病变为98例，癌性病变10例。 观察组110例患者中病理诊断证实非癌性病变95例，癌性病变15例。观察组诊 断EGC的特异性、阳性预测值及准确性明显高于对照组，差异均有统计学意义 (P0. 05)。结论 早期胃癌的筛查首选WLE,对于WLE发现的疑似病灶进一步行 ME-NBI检查并在ME-NBI指引下靶向活检有助于进一步提高诊断率。 关键词 早期胃癌;癌;放大胃镜;窄带成像技术; 2017-06-22 Application of narrow band imaging endoscopy in the diagnosis of early gastrie cancer YE Chunrong FU Xiaoyan HUANG hengqing Departmer^Lof Gastroenterology, The Second Peoples Hospital Aff订iated to Fujian University of Troditional Chinese Medicine; Abstract Objective To compare the diagnosis accuracy of NBI endoscopy ( ME-NBI) and white 1 ight endoscopy ( WLE) in the diagnosis of early gastric cancer, and to veiluEitc its value in ide nti fica tion of suspicious lcsi ons. Het hods Retrospectively analysed 218 patients found abnormal gastric lesions by WLE or ME-NBI. The patients were divided into observation group ( 110 cases) and control group ( 108 cases) according to the type of endoscopy. Observation group was given MENBT examirmtion, control group was given WLE examination. Two groups of lesions were biopsy or endoscopic rcscction of specimens pathological examination. Compared the endoscopic diagnosis and pathological diagnosis of two groups. Calculated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of endoscopic diagnosis- Results Tn control group, 80 cases of camccrous lesions were diagnosed by WLE cndoscopy, of which 10 cases were cancerous and 70 cases were non-cancerous confirmed by the final “gold standard pathological d