CAJ | 학술논문

目的探讨放大色素内镜结合窄带成像技术对可疑早期胃癌的临床诊断价值.方法选取2010年1月至2012年12月期间进行治疗的115例普通内镜观察下发现可疑早期胃癌病变患者,依次采用放大内镜、放大内镜结合窄带成像技术(ME-NBI)、放大色素内镜、放大色素内镜结合窄带成像技术,记录病变轮廓清晰度、黏膜腺管开口形态清晰度、微血管结构形态清晰度评分,并比较腺管开口分型和微血管形态分型.于病变改变最显著部位取活检行病理组织学检查,统计各方法对癌前病变诊断的准确率、灵敏度和特异度.结果放大色素内镜结合窄带成像技术病变轮廓和黏膜腺管开口清晰度评分为377分和458分,优于ME-NBI(340分和408分)和放大色素内镜(354分和386分)(P＜0.05),更优于放大内镜(276分和280分)(P＜0.01);放大色素内镜结合窄带成像技术病变微血管结构形态清晰度评分为380分,优于ME-NBI(348分)(P＜0.05),更优于放大内镜(267分)和放大色素内镜(280分)(P＜0.01).放大色素内镜结合窄带成像技术对绒毛状(C型)的检出率亦优于放大色素内镜(93.0％比79.7％,P＜0.05).放大色素内镜结合窄带成像技术对癌前病变诊断准确率为92.17％、灵敏度为88.33％、特异度为96.36％.结论放大色素内镜结合窄带成像能更清晰地观察到病变轮廓、黏膜腺管开口形态和微血管结构形态,明显提高病变的检出率,便于发现早期瘤变,值得进一步临床观察和推广.
목적 탐토방대색소내경결합착대성상기술대가의조기위암적림상진단개치.방법 선취2010년1월지2012년12월기간진행치료적115례보통내경관찰하발현가의조기위암병변환자,의차채용방대내경、방대내경결합착대성상기술(ME-NBI)、방대색소내경、방대색소내경결합착대성상기술,기록병변륜곽청석도、점막선관개구형태청석도、미혈관결구형태청석도평분,병비교선관개구분형화미혈관형태분형.우병변개변최현저부위취활검행병리조직학검사,통계각방법대암전병변진단적준학솔、령민도화특이도.결과 방대색소내경결합착대성상기술병변륜곽화점막선관개구청석도평분위377분화458분,우우ME-NBI(340분화408분)화방대색소내경(354분화386분)(P＜0.05),경우우방대내경(276분화280분)(P＜0.01);방대색소내경결합착대성상기술병변미혈관결구형태청석도평분위380분,우우ME-NBI(348분)(P＜0.05),경우우방대내경(267분)화방대색소내경(280분)(P＜0.01).방대색소내경결합착대성상기술대융모상(C형)적검출솔역우우방대색소내경(93.0％비79.7％,P＜0.05).방대색소내경결합착대성상기술대암전병변진단준학솔위92.17％、령민도위88.33％、특이도위96.36％.결론 방대색소내경결합착대성상능경청석지관찰도병변륜곽、점막선관개구형태화미혈관결구형태,명현제고병변적검출솔,편우발현조기류변,치득진일보림상관찰화추엄.
Objective To explore the clinical diagnostic value of narrow-band imaging combined with magnification chromoendoscopy for suspicious neoplasia lesions of early gastric cancer.Methods A total of 115 patients which had been diagnosed as having suspicious lesions byconventional endoscopy were enrolled from Jan.2010 to Dec.2012.They were observed by magnifying endoscopy(C-WLI), magnifying endoscopy combined with narrow-band imaging (ME-NBI), magnification chromoendoscopy and magnification chromoendoscopy combined with narrow-band imaging, respectively.The lesion outline sharpness, opening of the gland sharpness and microvascular morphology sharpness were recorded and the subtypes of opening of the gland and microvascular morphology were compared.The histological examination was performed on the most significant changes in lesion site and the accuracy, sensitivity and specificity of the four procedures were calculated.Results The score of outline sharpness was 377 and the score of pit sharpness was 458 by magnification chromoendoscopy combined with narrow-band imaging, higher than those of ME-NBI (340 and 408 respectively) and magnification chromoendoscopy (354 and 386 respectively) (P ＜ 0.05), significantly higher than those of C-WLI (276 and 280 respectively) (P ＜ 0.01).The score of microvascular morphology sharpness was 380 by magnification chromoendoscopy combined with narrow-band imaging,higher than that of ME-NBI (348, P ＜ 0.05), C-WLI (267, P ＜ 0.01) and magnification chromoendoscopy (280, P ＜ 0.01).The detection rate of C type by magnification chromoendoscopy combined with narrow-band imaging was higher than that by magnification chromoendoscopy (93.0％ VS 79.7％, P ＜ 0.05).The accuracy, sensitivity and specificity of magnification chromoendoscopy combined with narrow-band imaging was 92.17％, 88.33％ ,96.36％ respectively.Conclusion Narrow-band imaging endoscopy combined with pigment amplification can yield more clear image of the microvascular morphology and opening of the gland, significantly improve the lesion detection rate, reduce the missing rate, and is worthy of further clinical observation and promotion.