CAJ | 학술논문

目的：探讨内镜窄带成像（NBI）结合高清放大内镜（ME）应用 VS 分类标准对胃早期癌性病变的诊断价值。方法选取2013年1月-2014年6月行普通白光胃镜检查提示存在胃黏膜粗糙、糜烂、色泽异常、隆起或浅溃疡等疑似早期癌病例100例，采用自身对照法，对病例先行普通白光内镜观察并活检，2周后对同一病例再进行 NBI-ME 观察并活检，均以病理诊断为标准；A 组采用 NBI-ME，应用 VS 分类标准作出内镜下诊断；B 组采用白光内镜技术诊断。比较两组的敏感度、特异度、阳性预测值、阴性预测值和准确度。结果普通白光胃镜诊断胃早期癌性病变的敏感度、特异度、阳性预测值、阴性预测值、准确度分别为76.19％（16／21）、45.57％（36／79）、27.12％（16／59）、87.80％（36／41）、52.00％（52／100）；NBI-ME 诊断胃早期癌性病变的敏感度、特异度、阳性预测值、阴性预测值、准确度分别为95.24％（20／21）、97.47％（77／79）、90.91％（20／22）、98.72％（77／78）、97.00％（97／100）。两组准确度相比差异存在统计学意义（χ2＝53.30，P ＜0.01）。结论NBI-ME 应用 VS 分类标准具有简洁、实用，与病理符合率高的特点，在胃早期癌性病变的诊断中有良好的临床应用价值。
목적：탐토내경착대성상（NBI）결합고청방대내경（ME）응용 VS 분류표준대위조기암성병변적진단개치。방법선취2013년1월-2014년6월행보통백광위경검사제시존재위점막조조、미란、색택이상、륭기혹천궤양등의사조기암병례100례，채용자신대조법，대병례선행보통백광내경관찰병활검，2주후대동일병례재진행 NBI-ME 관찰병활검，균이병리진단위표준；A 조채용 NBI-ME，응용 VS 분류표준작출내경하진단；B 조채용백광내경기술진단。비교량조적민감도、특이도、양성예측치、음성예측치화준학도。결과보통백광위경진단위조기암성병변적민감도、특이도、양성예측치、음성예측치、준학도분별위76.19％（16／21）、45.57％（36／79）、27.12％（16／59）、87.80％（36／41）、52.00％（52／100）；NBI-ME 진단위조기암성병변적민감도、특이도、양성예측치、음성예측치、준학도분별위95.24％（20／21）、97.47％（77／79）、90.91％（20／22）、98.72％（77／78）、97.00％（97／100）。량조준학도상비차이존재통계학의의（χ2＝53.30，P ＜0.01）。결론NBI-ME 응용 VS 분류표준구유간길、실용，여병리부합솔고적특점，재위조기암성병변적진단중유량호적림상응용개치。
Objective To study the diagnostic value of NBI combined with magnification endoscopy using VS classification standard for early gastric carcinoma lesions.Methods A total of 100 patients with suspected early gastric cancer whose gastric mucosa showed roughness,erosion,abnormal colour or ulcer were collected from January 2013 to June 2014.The lesions were observed under white light endoscopy and then underwent biopsy.Observation and biopsy were conducted in the same location by NBI-ME with self contrast method 2 weeks later.Patients in group A underwent NBI-ME,then were diagnosed by VS classifi-cation standard.Patients in group B were diagnosed with white light endoscopy.The sensitivity,specificity, positive predictive value,negative predictive value and accuracy between group A and group B were com-pared.Results The sensitivity,specificity,positive predictive value,negative predictive value and accura-cy of white light endoscopy in the diagnosis of early gastric carcinoma lesions were 76.19% (16 /21 ), 45.57%(36 /79),27.12%(16 /59),87.80%(36 /41)and 52.00%(52 /100),respectively;while the these variables of NBI-ME for early gastric carcinoma lesions were 95.24%(20 /21),97.47%(77 /79), 90.91%(20 /22),98.72%(77 /78)and 97.00%(97 /100),respectively.The accuracy of NBI-ME for early gastric carcinoma lesions was significantly higher than that of white light endoscopy(χ2 =53.30,P <0.01).Conclusion NBI-ME is convenient and effective in the diagnosis of early gastric carcinoma lesions with high consistency of pathology and good clinical application value.