CAJ | 학술논문

背景：目前慢性萎缩性胃炎（ CAG）主要通过内镜加病理学检查确诊，窄带成像放大内镜（ NBI-ME）已较大范围应用于CAG的诊断，如何优化该项检查技术仍需进行研讨。目的：探讨NBI-ME诊断CAG、肠化生和上皮内瘤变的临床应用价值。方法：选取因CAG复查胃镜的患者100例，采用序贯检查方法，即首先在普通白光内镜（ C-WLI）下观察，确定病变范围，然后在NBI-ME模式下对病灶局部进行观察，分析胃黏膜腺管开口的形态变化。比较内镜检查结果与组织病理学结果。结果：序贯检查方法诊断CAG的敏感性为89.7%，特异性为63.3%；诊断肠化生的敏感性为89.4%，特异性为89.3%；诊断上皮内瘤变的敏感性为84.2%，特异性为95.9%。结论：采用序贯检查方法可明显提高CAG、肠化生和上皮内瘤变的诊断准确率，能有效指导靶向活检，且操作简便。
배경：목전만성위축성위염（ CAG）주요통과내경가병이학검사학진，착대성상방대내경（ NBI-ME）이교대범위응용우CAG적진단，여하우화해항검사기술잉수진행연토。목적：탐토NBI-ME진단CAG、장화생화상피내류변적림상응용개치。방법：선취인CAG복사위경적환자100례，채용서관검사방법，즉수선재보통백광내경（ C-WLI）하관찰，학정병변범위，연후재NBI-ME모식하대병조국부진행관찰，분석위점막선관개구적형태변화。비교내경검사결과여조직병이학결과。결과：서관검사방법진단CAG적민감성위89.7%，특이성위63.3%；진단장화생적민감성위89.4%，특이성위89.3%；진단상피내류변적민감성위84.2%，특이성위95.9%。결론：채용서관검사방법가명현제고CAG、장화생화상피내류변적진단준학솔，능유효지도파향활검，차조작간편。
Background:Currently,chronic atrophic gastritis( CAG)is diagnosed by endoscopy combined with pathological examination. Narrow-band imaging magnifying endoscopy( NBI-ME)has been widely applied to diagnose CAG. However, it is a issue how to optimize the examination technology. Aims:To investigate the clinical value of NBI-ME in diagnosis of CAG,intestinal metaplasia and intraepithelial neoplasia. Methods:One hundred CAG patients reexamined gastroscopy were enrolled,sequential examination was performd,i. e. the extent of disease was observed under convention white light endoscopy( C-WLI ) followed by NBI-ME mode to observe locally,morphological changes of gastric mucosa pit was analyzed,endoscopic findings and histological results was compared. Results:Sensitivity of sequential examination for the diagnosis of CAG was 89. 7%,specificity was 63. 3%;sensitivity and specificity for the diagnosis of intestinal metaplasia were 89. 4%,89. 3%,respectively,for intraepithelial neoplasia were 84. 2%,95. 9%,respectively. Conclusions:Sequential examination can significantly improve the diagnostic accuracies of CAG,intestinal metaplasia and intraepithelial neoplasia,and effectively guide targeted biopsy,and easily to operate.