CAJ | 학술논문

目的评价冰醋酸-靛胭酯增强的放大内镜(ME-AIM)和窄带成像增强的放大内镜(ME-NBI)对早期胃癌的诊断价值.方法对普通白光内镜(WLE)依据黏膜形态或色泽发生异常改变筛查出的317处局灶性病变先后行ME-NBI和ME-AIM检查,以活检病理学诊断结果为金标准,统计分析各种检查方法诊断早期胃癌的准确性.结果对于早期胃癌的诊断,ME-NBI的敏感度、特异度和准确率分别为100.0％ (11/11)、99.7％ (305/306)和99.7％(316/317),ME-AIM分别为90.9％(10/11)、99.0％ (303/306)和98.7％ (313/317),WLE分别为72.7％(8/11)、88.2％(270/306)和87.7％(278/317).ME-NBI和ME-AIM诊断早期胃癌的特异度和准确率显著高于WLE,差异均有统计学意义(P＜0.05);尽管ME-NBI和ME-AIM诊断早期胃癌的敏感度也高于WLE,但差异无统计学意义(P＞0.05).而ME-NBI与ME-AIM在诊断早期胃癌的敏感度、特异度和准确率方面差异均无统计学意义(P＞0.05).结论 WLE仍然是早期胃癌筛查首选的检查方法.ME-NBI和ME-AIM均能提高诊断的准确性,且两者诊断价值相似.
목적 평개빙작산-전연지증강적방대내경(ME-AIM)화착대성상증강적방대내경(ME-NBI)대조기위암적진단개치.방법 대보통백광내경(WLE)의거점막형태혹색택발생이상개변사사출적317처국조성병변선후행ME-NBI화ME-AIM검사,이활검병이학진단결과위금표준,통계분석각충검사방법진단조기위암적준학성.결과 대우조기위암적진단,ME-NBI적민감도、특이도화준학솔분별위100.0％ (11/11)、99.7％ (305/306)화99.7％(316/317),ME-AIM분별위90.9％(10/11)、99.0％ (303/306)화98.7％ (313/317),WLE분별위72.7％(8/11)、88.2％(270/306)화87.7％(278/317).ME-NBI화ME-AIM진단조기위암적특이도화준학솔현저고우WLE,차이균유통계학의의(P＜0.05);진관ME-NBI화ME-AIM진단조기위암적민감도야고우WLE,단차이무통계학의의(P＞0.05).이ME-NBI여ME-AIM재진단조기위암적민감도、특이도화준학솔방면차이균무통계학의의(P＞0.05).결론 WLE잉연시조기위암사사수선적검사방법.ME-NBI화ME-AIM균능제고진단적준학성,차량자진단개치상사.
Objective To investigate the diagnostic value of magnifying endoscopy enhanced by acetic acid-indigo carmine mixture (ME-AIM) and magnifying endoscopy enhanced with narrow-band imaging (ME-NBI) in the diagnosis of early gastric cancer (EGC).Methods A total of 317 focal gastric lesions,determined by WLE on the basis of the assessment of mucosal shape and color,were further characterized with ME-NBI and ME-AIM.The accuracy of each endoscopic method for the diagnosis of EGC was compared with the pathological results as the gold standard.Results For the diagnosis of EGC,the sensitivity,specificity,and accuracy of ME-NBI were 100.0％ (11/11),99.7％ (305/306) and 99.7％ (316/317)respectively; those of ME-AIM were 90.9％ (10/11),99.0％ (303/306) and 98.7％ (313/317) respectively; those of WLE were 72.7％ (8/11),88.2％ (270/306)and 87.7％ (278/317)respectively.The specificity and accuracy of both ME-NBI and ME-AIM were significantly better than those of WLE (P ＜0.05).Both ME-NBI and ME-AIM had higher sensitivity than WLE,but the difference was not significant (P ＞ 0.05).ME-NBI was not superior to ME-AIM in the diagnosis of EGC (P ＞ 0.05).Conclusion WLE is still a useful modality in screening EGC.BothME-NBI and ME-AIM can improve the diagnostic accuracy in comparison with WLE,but ME-NBI is not superior to ME-AIM in identifying EGC.