CAJ | 학술논문

目的：探讨窄带成像放大内镜技术（NBI-M E）在血清癌胚抗原（CEA ）阳性病例中进行微血管分型诊断胃癌和肠癌的临床价值。方法搜集2012～2013年在该院检测血清CEA结果为阳性的病例873例，将通过初诊为疑似胃癌的114例和疑似大肠癌的35例患者纳入研究。利用NBI-M E检查并切取组织进行病理活检。NBI-M E检查重点观察微血管性状并进行分型：规则型、稍不规则型、不规则型、消失型，将微血管分型情况与病理检查结果进行对比。结果病理确诊为癌症13例，检出率为8．72％；上皮内瘤变10例，检出率为6．71％。规则型和稍不规则型中无癌症病例，在消失型中无非癌性病例。消失型对癌症的灵敏度为100．00％，而不规则型对癌变可能性大的肠化生萎缩和高级别上皮内瘤变的灵敏度为87．50％，差异有统计学意义（P＜0．05）。结论利用NBI-ME观察病变处微血管分型诊断可以帮助在CEA阳性病例中筛查出胃癌和肠癌。
목적：탐토착대성상방대내경기술（NBI-M E）재혈청암배항원（CEA ）양성병례중진행미혈관분형진단위암화장암적림상개치。방법수집2012～2013년재해원검측혈청CEA결과위양성적병례873례，장통과초진위의사위암적114례화의사대장암적35례환자납입연구。이용NBI-M E검사병절취조직진행병리활검。NBI-M E검사중점관찰미혈관성상병진행분형：규칙형、초불규칙형、불규칙형、소실형，장미혈관분형정황여병리검사결과진행대비。결과병리학진위암증13례，검출솔위8．72％；상피내류변10례，검출솔위6．71％。규칙형화초불규칙형중무암증병례，재소실형중무비암성병례。소실형대암증적령민도위100．00％，이불규칙형대암변가능성대적장화생위축화고급별상피내류변적령민도위87．50％，차이유통계학의의（P＜0．05）。결론이용NBI-ME관찰병변처미혈관분형진단가이방조재CEA양성병례중사사출위암화장암。
Objective To study clinical diagnosis value of using magnifying endoscopy with narrow-band imaging(NBI-ME) in the CEA positive cases of microvascular parting to gastric cancer and colorectal cancer .Methods 873 cases in our hospital from 2012~2013 ,who had serum CEA positive were choosen ,the 114 patients who first diagnosis for suspected gastric cancer ,35 pa-tients who first diagnosis forsuspected colorectal cancer were included in this study .Using NBI-ME to check and the pathology bi-opsy .NBI-M E check key observation microvascular properties and classification :rules ,slightly irregular ,irregular ,disappeared ,the microvascular parting situation compared with pathological findings .Results 13 patients diagnosed with cancer by pathology ,the positive rate was 8 .72% ;intraepithelial neoplasia in 10 cases ,the positive rate was 6 .71% .No cases of cancer were regular and slightly irregular type ,all cancer cases in the disappearance .The sensitivity of type of disappeared was 100 .00% ,and the sensitivity of irregular type of canceration possibility intestinal large atrophy and high grade intraepithelial neoplasia was 87 .50% ,the differ-ence was statistically significant(P<0 .05) .Conclusion Using NBI-ME microvascular classification diagnosis could help observa-tion CEA positive cases in the screening of gastric cancer and colorectal cancer .