摘要
目的:研究放大内镜(ME)联合窄带成像技术(NBI)在早期胃癌(EGC)及癌前病变中的诊断价值。方法:选取2023年6月至2024年7月因各种原因于新疆生产建设兵团医院内镜中心行常规内镜检查时发现可疑病变的患者200例作为研究对象,根据就诊顺序进行编号,单号纳入对照组,行普通白光内镜检查并活检;双号纳入观察组,行ME联合NBI检查并活检。分别记录两组患者检查图像的质量、内镜诊断结果,以活检病理诊断结果为金标准,分析两种检查方法在EGC及癌前病变的诊断价值。结果:观察组在病灶边界判断及病灶表面微结构方面,图像清晰度评分高于对照组,差异具有统计学意义(χ^(2)=60.78,P<0.01);观察组的诊断结果与病理诊断的一致性为几乎完全一致(κ=0.84,P<0.05),而普通白光内镜为一般的一致(κ=0.34,P<0.05)。观察组的诊断灵敏度(87.88%vs.51.43%)、特异度(95.52%vs.81.54%)、准确度(93.00%vs.71.00%)、阳性预测值(90.63%vs.60.00%)、阴性预测值(94.12%vs.75.71%)均高于对照组,差异均具有统计学意义(P<0.05)。结论:ME联合NBI在EGC及癌前病变中有更优的诊断价值。
Objective To investigate the diagnostic value of magnifying endoscopy(ME)combined with narrow-band imaging(NBI)in early gastric cancer(EGC)and precancerous lesions.Methods A total of 200 patients with suspicious lesions detected during routine endoscopy at the Endoscopy Center of Xinjiang Production and Construction Corps Hospital between June 2023 and July 2024 were enrolled.Participants were numbered sequentially based on their visit order,with odd-numbered patients assigned to the control group(conventional white-light endoscopy with biopsy)and even-numbered patients to the observation group(ME-NBI combined examination with biopsy).Image quality,endoscopic diagnostic results,and histopathological findings(as the gold standard)were recorded for both groups.The diagnostic performance of the two methods was compared.Results The observation group achieved significantly higher image clarity scores for lesion boundary demarcation and surface microstructure compared to the control group(χ^(2)=60.78,P<0.01).The diagnostic consistency between ME-NBI and histopathology was almost perfect(κ=0.84,P<0.05),whereas conventional white-light endoscopy showed only moderate agreement(κ=0.34,P<0.05).The observation group demonstrated superior diagnostic sensitivity(87.88%vs.51.43%),specificity(95.52%vs.81.54%),accuracy(93.00%vs.71.00%),positive predictive value(90.63%vs.60.00%),and negative predictive value(94.12%vs.75.71%)compared to the control group,with all differences being statistically significant(P<0.05).Conclusion ME combined with NBI exhibits superior diagnostic value for EGC and precancerous lesions.
作者
何海港
车丽红
张爱梅
赵振刚
王新娟
HE Haigang;CHE Lihong;ZHANG Aimei;ZHAO Zhengang;WANG Xinjuan(Xinjiang Production and Construction Corps Hospital,Xinjiang Urumqi 830002;Tianjin Third Central Hospital,Tianjin 300170)
出处
《兵团医学》
2025年第1期5-8,共4页
Journal of BingTuan Medicine
基金
新疆生产建设兵团医院青年基金项目(2023020)
关键词
早期胃癌
胃癌前病变
放大内镜
窄带成像技术
白光内镜
Early gastric cancer
Gastric precancerous lesions
Magnifying endoscopy
Narrow-band imaging
White-light endoscopy
