窄带成像技术联合放大内镜在早期胃癌诊断中的价值

目的:评估比较窄带成像技术联合放大内镜(narrow band imaging-magnifying endoscopy,NBI-ME)在早期胃癌诊断中价值。方法:115例早期胃癌患者行NBI-ME观察,采集照片并做出内镜下诊断,于病灶最明显处取活检并行病理检查。所有患者接受内镜下治疗,术后行病理活检。分别计算NBI-ME、内镜活检诊断早期胃癌的敏感度、特异度、阳性预测值、阴性预测值、准确率。结果:115例患者纳入本研究,最终术后切除病理示低级别上皮内瘤变(low-grade neoplasia,LGIN)16例,高级别上皮内瘤变(high-grade neoplasia,HGIN)30例,分化型胃癌59例,未分化型胃癌10例。NBI-ME诊断早期胃癌的敏感度、特异度、阳性预测值、阴性预测值、准确率分别为98.0%、81.3%、97.0%、86.7%、95.7%,内镜活检的对应值分别为82.8%、87.5%、97.6%、45.2%、83.5%。NBI-ME诊断早期胃癌的敏感度及准确率均明显高于内镜活检(P0.05)。结论:NBI-ME对早期胃癌具有较高诊断价值。

Value of Narrow-band Imaging Combined with Magnifying Endoscopy in Diagnosis of Early Gastric Cancer

ABSTRACT Objective: To evaluate the diagnostic performance of narrow-band imaging combined with magnifying endoscopy (NBI-ME) for diagnosis of early gastric cancer. Methods: Patients (115 cases) with early gastric lesions were enrolled in the study and ex- amined by NBI-ME. Biopsy specimen was taken from suspicious lesions for pathological examination. All patients received endoscopic resection. The diagnostic ability of different methods will be compared. Results: A total of 115 patients in the study, 65men and 50 wom- en. The final pathology showed 16 cases of low grade intraepithelial neoplasia, high grade intraepithelial neoplasia in 30 cases, 59 cases of differentiated gastric cancer, and 10 cases of undifferentiated gastric cancer. The sensitivity, specificity, positive predictive value, neg- ative predictive value and accuracy of NBI-ME for diagnosing early gastric cancer were 98.0 %, 81.3 %, 97.0 %, 86.7 %, 95.7 %, respectively. The counterparts of endoscopic biopsy for diagnosing early gastric cancer were 82.8 %, 87.5 %, 97.6 %, 45.2 %, 83.5 %, respectively. The sensitivity and accuracy of NBI-ME were significantly better than that of endoscopic biopsy (P<0.05). Conclusion: NBI-ME has value in diagnosis for early gastric cancer.